Skip to main content

27.03.2019 | Original article | Ausgabe 4/2019

International Journal of Public Health 4/2019

The relationship between health literacy and health outcomes among male young adults: exploring confounding effects using decomposition analysis

International Journal of Public Health > Ausgabe 4/2019
René Rüegg, Thomas Abel
Wichtige Hinweise

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations



Previous studies indicate substantial correlations between low health literacy and poor health outcomes. However, empirical findings remain inconsistent and are theoretically challenging. In this study, we conceptually place health literacy within an established model of health inequality. Studying multiple pathways, we estimate the associations between health literacy and six health outcomes and decompose these associations with health literacy’s covariates.


Cross-sectional data from the Young Adult Survey Switzerland was used for the analyses (n = 5959, age = 18–25). Logistic regression and KHB decomposition analyses were applied to estimate health literacy’s coefficients and confounding percentages.


Eleven covariates were associated with health literacy (p < 0.001). Ten covariates reduced the naïve health literacy coefficient when included in the regression models (confounding percentages: 36.7–86.9%). In three out of six models, the confounding effects led to non-significant health literacy coefficients.


We found that health literacy’s associations with health outcomes are confounded by socioeconomic, material, psychosocial, and health-related factors. More investigations on the causal importance of health literacy, respectively, on its potential to health promotion are required.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

e.Med Interdisziplinär

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf

Jetzt e.Med zum Sonderpreis bestellen!

Sichern Sie sich jetzt Ihr e.Med-Abo und sparen Sie 50 %!

Über diesen Artikel

Weitere Artikel der Ausgabe 4/2019

International Journal of Public Health 4/2019 Zur Ausgabe