Motivation for a health-literate health care system--does socioeconomic status play a substantial role? Implications for an Irish health policymaker

Abstract

In this article, the authors argue that the association between socioeconomic status and motivation for a health-literate health care system has implications for health policymakers. As Ireland now undergoes health care reform, the authors pose the question, "Should policymakers invest in health literacy as predominately a health inequalities or a public health issue?" Data from 2 cohorts of the Survey of Lifestyle, Attitudes and Nutrition (1998 and 2002) were used to construct a motivation for a health-literate health care system variable. Multivariate logistic regressions and concentration curves were used in the analyses of this variable. Of the 12,513 pooled respondents, 46% sought at least 1 attribute on a health-literate health care system. No discernible trend emerged from the main independent variables-social class grouping, medical card eligibility, level of education, and employment-in the regression analyses. The concentration curve, for 2002 data, graphically showed that the motivation for a health-literate health care system is spread equally across the income distribution. This analysis and more recent data suggest that health literacy in Ireland should be viewed predominately as a public health issue with a policy focus at a system level.

Figure 1.

This simplistic conceptual model outlines the characteristics of respondents available from SLAN surveys that contribute to a respondent's motivation for a health literate health care system.

Figure 2.

Concentration curve: Desire for a health-literate health care system (2002 SLAN data only).