Skip to main content

Table 2 Summary of the 19 publications included in a systematic review and meta-analysis on the association between HL and mortality from 2006 to 2020

From: Association between health literacy and mortality: a systematic review and meta-analysis

Author Location Design Study population Sample size Sex (% male) Death HL instrument low HL Study conclusion Adjusted NOS score
Baker et al. 2008 [24] USA prospective cohort Elderly 3260 1388 (42.6%) 815 S-TOFHLA 1166 HR: 1.25
95%CI: 0.86–1.82
age, sex, race, education, income, language, SF-36 physical functioning, mental health component scores, number of chronic diseases, number of impairments in activities of daily living, number of impairments in instrumental activities of daily living, city of enrollment 9
Bostock et al. 2012 [34] UK retrospective cohort Elderly 7857 3515 (44.7%) 621 4-item test 2579 HR: 1.15
95%CI: 0.79–1.67
age, sex, race, education, wealth, occupation, health status (limiting illness, limited activities of daily living, depressive symptoms, self reported doctor diagnosed disease: heart disease, diabetes, stroke, cancer, asthma, chronic lung disease), health behaviors (smoking, exercise, alcohol consumption), cognitive (orientation in time, immediate recall of word list, fluency in an animal naming task) 12
Cavanaugh et al. 2010 [25] USA prospective cohort Hemodialysis
patients
480 269 (56.0%) 103 REALM 154 HR: 1.51
95%CI: 0.99–2.30
age, sex, race, diabetes status, baseline serum albumin. 11
Fabbri et al. 2018 [26] USA prospective cohort HF 2487 1333 (53.6%) 250 BHLS 261 HR: 1.91
95%CI: 1.38–2.65
age, sex, education, marital status, CCI 12
Fawns-Ritchie et al. 2018 [27] UK prospective cohort Elderly 795 336 (42.3%) 130 S-TOFHLA、NVS
REALM
General functional health literacy
38 ± 3.85 score HR: 1.00
95%CI: 0.95–1.05
age, sex, education, age-11 IQ, current fluid ability in older age, occupational class, health status 10
Ferri-Guerra et al. 2020 [35] USA retrospective cohort Veterans 470 470 (100%) 63 NVS 258 HR: 1.08
95%CI: 0.95–1.22
age, race, educational, median household income, CCI, hospitalizations in the previous year 12
León-González et al. 2018 [17] Spain prospective cohort HF 556 210 (37.5%) 189 SAHLSA 370 HR: 1.05
95%CI: 0.65–1.68
age, sex, education, treatment group (intervention, no intervention), hospital, NYHA, LVEF, atrial fibrillation, serum hemoglobin, serum creatinine, depression, CCI, Katz index, Mini-Mental State Examination, hospitalization for HF in last year, HF knowledge score, HF self-care score. 11
Mayberry et al. 2018 [28] USA prospective cohort CVD 2977 1602 (53.8%) 304 BHLS
S-TOFHLA、SNS-3
506 OR: 1.31
95%CI: 1.01–1.69
age, sex, race, socioeconomic status (employed, disabled, financial strain, income, underinsured) 9
McNaughton et al. 2015 [16] USA retrospective cohort HF 1379 813 (59.0%) 403 BHLS 324 HR: 1.32
95%CI: 1.05–1.66
age, sex, race, education, insurance, index hospitalization length of stay, disease severity 10
Metin et al. 2019 [36] Turkey retrospective cohort Palliative care patients 242 147 HLS-EU 195 HR: 1.44
95%CI: 0.90–2.32
age, height, weight, tracheostomy presence, triceps circumference, food intake status of the patients 10
Peterson et al. 2011 [37] USA retrospective cohort HF 1494 699 (46.8%) 124 BHLS 262 HR: 1.04
95%CI: 0.79–1.37
age, sex, race, education, socioeconomic status, self-reported physical function, residential status (independent vs. nursing facility or hospice care), serum creatinine, LVEF, year of cohort entry 11
Smith et al. 2018 [38] UK retrospective cohort Elderly 7731 3460 (44.8%) 1259 4-item test 959 HR: 1.22
95%CI: 1.03–1.46
age, sex, race, education, occupational class, wealth quintile, health status (limiting illness, functional impairment, depressive, self-reported doctor-diagnosed disease: heart disease, diabetes, cancer, stroke, asthma, chronic lung disease), health behaviors (smoke, exercise,alcohol consumption), cognitive (time orientation, recall of word list, fluency on an animal naming task), social isolation 10
Stewart et al. 2020 [29] USA prospective cohort Elderly 931 158 (17.0%) 224 9-item instrument 65.8% correct HR: 1.01
95%CI: 1.00–1.02
age, sex, education, income, lower total, health, financial literacy, medical conditions, physical activity, depressive symptoms, cognitive 11
Sudore et al. 2006 [30] USA prospective cohort Elderly 2512 1225 (48.8%) 320 REALM 595 HR: 1.75
95%CI: 1.27–2.41
age, sex, race, education, income, health status (self-rated health, cardiac disease, stoke, cancer, hypertension, diabetes, obesity), health behaviors (smoke, alcohol consumption), health care access measures, psychosocial status 9
Taylor et al. 2019 [31] UK prospective cohort CKD 2274 1474 (64.8%) 338 BHLS 364 HR: 1.05
95%CI: 0.73–1.49
age, sex, race, education, language, primary renal diagnosis, CCI, car ownership 9
Warsame et al. 2019 [32] USA prospective cohort KT 1578 1205 (76.4%) 54 BHLS 140 HR: 2.42
95%CI: 1.16–5.05
age, sex, race, cause of end-stage renal disease, blood type 9
Wolf et al. 2010 [39] USA retrospective cohort Elderly 2956 417 S-TOFHLA 643 HR: 1.95
95%CI: 1.37–2.77
age, sex, race, education, income, occupational class, number of chronic conditions, physical functioning, activity limitations, mental health 12
Wu et al. 2013 [33] USA prospective cohort HF 595 309 (51.9%) 16 S-TOFHLA 220 RR: 1.31
95%CI: 1.06–1.63
age, sex, race, education,income, site, insurance, systolic blood pressure, systolic dysfunction, NYHA, diabetes, hypertension, atrial fibrillation, history of CVD (MI or angina), beta-blocker use, HF symptoms, HF general knowledge, salt knowledge, self-efficacy, self-care behaviors HF 12
Wu et al. 2016 [40] USA retrospective cohort HF 575 341 (59.3%) 63 S-TOFHLA 206 HR: 1.80
95%CI: 1.29–2.50
age, sex, race, income, marital status, employed, LVEF, NYHA, BNP, ACEI user, beta-blocker user, intervention group 10
  1. ACEI angiotensin-converting enzyme inhibitor, BHLS the Brief Health Literacy Screen, BNP B-natriuretic peptide, CCI Charlson Comorbidity Index, CI confidence interval, CKD chronic kidney disease, CVD chronic kidney disease, HF heart failure, HLS-EU Health Literacy Survey-European Union-Questionnaire, HR hazard ratio, KT kidney transplant, LVEF left ventricular ejection fraction, MI myocardial infarction, NVS the Newest Vital Sign, NYHA New York Heart Association, REALM the Rapid Estimate of Adult Literacy in Medicine, SAHLSA the Short Assessment of Health Literacy for Spanish-speaking Adults, SNS-3 3-item version of the Subjective Numeracy Scale, S-TOFHLA the short Test of Functional Health Literacy in Adults