Background
Methods
Study population and sampling
Interview and measures
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Educational level, based on self-reported highest level of attained qualification. Low educational attainment level refers to having no qualifications at all, or having fewer than 5 General Certificate of Secondary Education (GCSE) at grades A-C. The latter is comparable to level 0-2 in the International Standard Classification of Education (ISCED) mapping [20]. Intermediate educational attainment level refers to 5 or more GCDE’s 2 or more A levels, or nursing and teaching qualifications (ISCED level 3-5); High educational attainment level refers to doctorate/masters/bachelor or at least first degree post graduate certificate in education. This is comparable to level 6-8 in the ISCED mapping [20].
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Self-rated literacy, estimated by individuals’ self-reported confidence in reading written English. Respondents were asked ‘How confident do you feel with reading written English?’. Responses were provided on a 4 point scale; not confident at all (1); not confident (2); quite confident (3); very confident (4).
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Ethnic background, assessed by self-identification. Respondents were asked to which ethnic group they considered themselves to belong.
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Long term conditions, assessed by asking the participant whether he or she has a long standing illness, disability or infirmity. If yes, the respondent was asked to indicate the type of illness, disability or infirmity by choosing from a list. Cardiovascular condition was defined as having heart disease/ stroke/ high bloodpressure. Diabetes mellitus was defined as having type I or II diabetes, depression was defined as using medication for depression.
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Self-rated health was measured by the item ‘In general, how would you say your health is?’ Responses were provided on a 5 point scale from ‘very bad’ (1) to ‘very good’ (5).
Analyses
Results
Characteristics of the study population
N (%) | |
---|---|
Educational attainment level* | |
Low | 1875 (44) |
Intermediate | 1266 (30) |
High | 1016 (24) |
Age | |
25-34 | 925 (22) |
35-44 | 952 (22) |
45-54 | 812 (19) |
55-64 | 835 (19) |
65-74 | 751 (18) |
Gender (female) | 2432 (57) |
Self-rated literacy** | |
Not confident at all in reading English | 77 (2) |
Not very confident in reading English | 142 (3) |
Quite confident in reading English | 522 (12) |
Very confident in reading English | 3529 (82) |
Ethnic background | |
White British/English | 3420 (80) |
Other White | 218 (5) |
South Asian | 287 (7) |
African/Caribean | 226 (5) |
Mixed | 56 (1) |
Other/prefer not to answer | 68 (2) |
Educational differences in self-rated literacy and health outcomes
Educational level | |||
---|---|---|---|
Low (n = 1875) | Intermediate (n = 1266) | High (n = 1016) | |
Self-rated health*
| |||
Good | 1281 (68) | 970 (77) | 853 (84) |
Neutral | 259 (13) | 164 (13) | 110 (11) |
Bad | 333 (18) | 129 (10) | 52 (5) |
Long term condition**
| |||
General LTC | 905 (48) | 454 (36) | 252 (25) |
Cardiovascular disease | 547 (29) | 226 (18) | 122 (14) |
Stomach, liver, kidney, digestive problems | 171 (9) | 101 (8) | 66 (6) |
Diabetes Mellitus (I/II) | 173 (9) | 65 (5) | 36 (3) |
Mental health problems/depression/stress | 258 (14) | 119 (9) | 62 (6) |
Asthma | 246 (13) | 134 (11) | 84 (8) |
Educational level | |||
---|---|---|---|
Low (n = 1872) | Intermediate (n = 1266) | High (n = 1015) | |
Self-rated literacy*
| |||
Not confident at all reading English | 66 (4) | 6 (1) | 2 (0) |
Not very confident reading English | 93 (5) | 36 (3) | 9 (1) |
Quite confident reading English | 283 (15) | 146 (11) | 70 (7) |
Very confident reading English | 1430 (76) | 1078 (85) | 934 (92) |
Association between educational level and long term conditions
OR (95% CI) | |
---|---|
Long term condition in general
| |
Model 1.1: Educational level | 2.04 (1.80-2.32) |
Model 1.2: Educational level + literacy | 2.02 (1.78-2.29) |
Model 1.3: Educational level + age | 1.49 (1.30-1.70) |
Model 1.4: Educational level + ethnicity | 1.95 (1.30-1.68) |
Model 1.5: Educational level + gender | 2.07 (1.82-2.35) |
Model 1.6: Educational level + literacy + age + ethnicity + gender | 1.37 (1.19-1.58) |
Cardiovascular condition
| |
Model 2.1: Educational level | 2.21 (1.90-2.57) |
Model 2.2: Educational level + literacy | 2.28 (1.95-2.65) |
Model 2.3: Educational level + age | 1.24 (1.05-1.47) |
Model 2.4: Educational level + ethnicity | 2.12 (1.82-2.46) |
Model 2.5: Educational level + gender | 2.22 (1.91-2.57) |
Model 2.6: Educational level + literacy + age + ethnicity + gender | 1.20 (1.01-1.34) |
Diabetes Mellitus
| |
Model 3.1: Educational level | 2.10 (1.63-2.68) |
Model 3.2: Educational level + literacy | 2.09 (1.62-2.69) |
Model 3.3: Educational level + age | 1.31 (1.01-1.70) |
Model 3.4: Educational level + ethnicity | 2.10 (1.63-2.70) |
Model 3.5: Educational level + gender | 2.18 (1.69-2.79) |
Model 3.6: Educational level + literacy + age + ethnicity + gender | 1.37 (1.04-1.80) |
Mental health/depression
| |
Model 4.1: Educational level | 1.87 (1.53-2.29) |
Model 4.2: Educational level + literacy | 1.78 (1.45-2.18) |
Model 4.3: Educational level + age | 2.05 (1.67-2.53) |
Model 4.4: Educational level + ethnicity | 1.81 (1.49-2.22) |
Model 4.5: Educational level + gender | 1.83 (1.49-2.23) |
Model 4.6: Educational level + literacy + age + ethnicity + gender | 1.79 (1.44-2.23) |
Association between educational level and self-rated health
OR (95% CI) | |
---|---|
Self-rated health | |
Model 5.1: Educational level | 1.83 (1.59-2.10) |
Model 5.2: Education + literacy | 1.70 (1.47-1.96) |
Model 5.3: Education + age | 1.67 (1.44-1.93) |
Model 5.4: Education + ethnicity | 1.83 (1.59-2.10) |
Model 5.5: Education + gender | 1.84 (1.60-2.11) |
Model 5.6: Education + literacy + age + ethnicity + gender | 1.51 (1.30-1.76) |