Health literacy: how essential for accessing and utilizing healthcare?

Abstract

In this thesis, health literacy has been examined in relation to migration background using an existing theoretical framework, in which is stated that health literacy is related to access and use of healthcare (operationalized as health actions and needs). Data from the ‘Gezondheidspeiling 2014’ of the Municipality of Utrecht were used to examine if health literacy could explain (e.g. mediate) the association between migration background and health actions and needs. It was found that people with a migration background overall had (slightly) lower health literacy and (slightly) more health actions and needs. However, this thesis did not show convincing evidence for mediation by health literacy of the association between migration background and health actions and needs. Although mediation effects were found, these were probably not relevant because of the high statistical power of this study. This thesis concludes that health literacy remains a relevant theme because people with a migration background tended to have lower health literacy and more unfulfilled health needs. However, the Municipality of Utrecht should also examine other processes that play a role in the association between migration background and health actions and needs because health literacy only played a minor mediating role.