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Health literacy, social support, and health: a research agenda

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  • Lee, Shoou-Yih D.
  • Arozullah, Ahsan M.
  • Cho, Young Ik

Abstract

Amid increased concerns about the adverse consequences of low health literacy, it remains unclear how health literacy affects health status and health service utilization. Moreover, studies have shown significant variation in individual adaptation to health literacy problems. This article proposes research hypotheses to address two questions: (1) What are the causal pathways or intermediate steps that link low health literacy to poor health status and high utilization of expensive services such as hospitalization and emergency care? (2) What impact does social support have on the relationships between health literacy and health service utilization? Empirical studies of health literacy are reviewed to indicate the limitations of current literature and to highlight the importance of the proposed research agenda. In particular, we note the individualistic premise of current literature in which individuals are treated as isolated and passive actors. Thus, low health literacy is considered simply as an individual trait independent of support and resources in an individual's social environment. To remedy this, research needs to take into account social support that people can draw on when problems arise due to their health literacy limitations. Examination of the proposed agenda will make two main contributions. First, we will gain a better understanding of the causal effects of health literacy and identify missing links in the delivery of care for patients with low health literacy. Second, if social support buffers the adverse effects of low health literacy, more effective interventions can be designed to address differences in individuals' social support system in addition to individual differences in reading and comprehension. More targeted and more cost-efficient efforts could also be taken to identify and reach those who not only have low health literacy but also lack the resources and support to bridge the unmet literacy demands of their health conditions.

Suggested Citation

  • Lee, Shoou-Yih D. & Arozullah, Ahsan M. & Cho, Young Ik, 2004. "Health literacy, social support, and health: a research agenda," Social Science & Medicine, Elsevier, vol. 58(7), pages 1309-1321, April.
    • Handle: RePEc:eee:socmed:v:58:y:2004:i:7:p:1309-1321
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    Cited by:

    1. Cho, Young Ik & Lee, Shoou-Yih D. & Arozullah, Ahsan M. & Crittenden, Kathleen S., 2008. "Effects of health literacy on health status and health service utilization amongst the elderly," Social Science & Medicine, Elsevier, vol. 66(8), pages 1809-1816, April.
    2. Ruoyu Wang & Desheng Xue & Ye Liu & Penghua Liu & Hongsheng Chen, 2018. "The Relationship between Air Pollution and Depression in China: Is Neighbourhood Social Capital Protective?," IJERPH, MDPI, vol. 15(6), pages 1-13, June.
    3. Wouters, Edwin & Van Damme, Wim & Van Loon, Francis & van Rensburg, Dingie & Meulemans, Herman, 2009. "Public-sector ART in the Free State Province, South Africa: Community support as an important determinant of outcome," Social Science & Medicine, Elsevier, vol. 69(8), pages 1177-1185, October.
    4. Uday Patil & Uliana Kostareva & Molly Hadley & Jennifer A. Manganello & Orkan Okan & Kevin Dadaczynski & Philip M. Massey & Joy Agner & Tetine Sentell, 2021. "Health Literacy, Digital Health Literacy, and COVID-19 Pandemic Attitudes and Behaviors in U.S. College Students: Implications for Interventions," IJERPH, MDPI, vol. 18(6), pages 1-14, March.
    5. Suryanaryana Murty Upadhyayula & Srinivasa Rao Mutheneni & Madhusudhan Rao Kadiri & Sriram Kumaraswamy & Balakrishna Nagalla, 2012. "A Cohort Study of Lymphatic Filariasis on Socio Economic Conditions in Andhra Pradesh, India," PLOS ONE, Public Library of Science, vol. 7(3), pages 1-8, March.
    6. Bas Geboers & Sijmen A. Reijneveld & Jaap A. R. Koot & Andrea F. De Winter, 2018. "Moving towards a Comprehensive Approach for Health Literacy Interventions: The Development of a Health Literacy Intervention Model," IJERPH, MDPI, vol. 15(6), pages 1-11, June.
    7. Yolanda Álvarez-Pérez & Lilisbeth Perestelo-Pérez & Amado Rivero-Santanta & Alezandra Torres-Castaño & Ana Toledo-Chávarri & Andrea Duarte-Díaz & Vinita Mahtani-Chugani & María Dolores Marrero-Díaz & , 2022. "Co-Creation of Massive Open Online Courses to Improve Digital Health Literacy in Pregnant and Lactating Women," IJERPH, MDPI, vol. 19(2), pages 1-15, January.
    8. Chinn, Deborah, 2011. "Critical health literacy: A review and critical analysis," Social Science & Medicine, Elsevier, vol. 73(1), pages 60-67, July.
    9. Joy Agner & Monet Meyer & Tyra Mahealani Kaukau & Maileen Liu & Lisa Nakamura & Adriana Botero & Tetine Sentell, 2023. "Health Literacy, Social Networks, and Health Outcomes among Mental Health Clubhouse Members in Hawai‘i," IJERPH, MDPI, vol. 20(1), pages 1-17, January.
    10. Dong, Gang Nathan, 2016. "Social capital as correlate, antecedent, and consequence of health service demand in China," China Economic Review, Elsevier, vol. 37(C), pages 85-96.
    11. Diane Levin-Zamir & Isabella Bertschi, 2018. "Media Health Literacy, eHealth Literacy, and the Role of the Social Environment in Context," IJERPH, MDPI, vol. 15(8), pages 1-12, August.
    12. Barata, Paula C. & Gucciardi, Enza & Ahmad, Farah & Stewart, Donna E., 2006. "Cross-cultural perspectives on research participation and informed consent," Social Science & Medicine, Elsevier, vol. 62(2), pages 479-490, January.
    13. Chengbo Li & Mengyao Liu & Jin Zhou & Mei Zhang & Huanchang Liu & Yuting Wu & Hui Li & George W. Leeson & Tingting Deng, 2022. "Do Health Information Sources Influence Health Literacy among Older Adults: A Cross-Sectional Study in the Urban Areas of Western China," IJERPH, MDPI, vol. 19(20), pages 1-19, October.

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