Measuring health literacy to inform actions to address health inequities: a cluster analysis approach based on the Australian national health literacy survey

Author:

Cheng Christina1ORCID,Elmer Shandell2,Batterham Roy3,Hawkins Melanie1,Osborne Richard H1

Affiliation:

1. Swinburne University of Technology Centre for Global Health and Equity, School of Health Sciences, , Hawthorn 3122, Victoria , Australia

2. School of Nursing College of Health and Medicine, College of Health and Medicine, University of Tasmania , Launceston 7250, Tasmania , Australia

3. Thammasat University Global Health Program, Faculty of Public Health, , Bangkok 10200 , Thailand

Abstract

Abstract Background Measuring health literacy can inform interventions to address health inequities. This study used cluster analysis to examine health literacy data to determine if it can provide more insightful information than standard descriptive analysis to better inform intervention development. Methods Using data from the Australian National Health Survey (2018), this study compared descriptive analysis and cluster analysis results of two states—New South Wales (NSW) and Victoria—generated from the Health Literacy Questionnaire (HLQ). Based on the nine scale scores of the HLQ, a hierarchical cluster analysis using Ward’s method for linkage was undertaken. Results The number of NSW and Victoria respondents was 1018 and 923, respectively. The nine HLQ scale full sample mean scores from both states were similar. However, the cluster analyses identified 11 clusters for NSW and 12 clusters for Victoria. While six clusters from each state presented similar health literacy patterns, five and six clusters from NSW and Victoria, respectively, displayed unique health literacy patterns. Conclusions The results demonstrate that descriptive analysis only provides an overview and may lead to one-size-fits-all interventions. The varying health literacy patterns among subgroups resulting from the cluster analysis pave the way to inform tailored actions to improve health equity.

Funder

National Health and Medical Research Council of Australia Principal Research Fellowship

Publisher

Oxford University Press (OUP)

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