Large diversity in Danish health literacy profiles: perspectives for care of long-term illness and multimorbidity

Abstract Background Health literacy is an important, modifiable, social determinant of health. This study aims to explore health literacy challenges of people with long-term illness or multimorbidity and provide detailed profiles revealing health literacy strengths and weaknesses within a Danish population. Methods In this cross-sectional study among Danish individuals (n = 490), health literacy was assessed using the nine-scale Health Literacy Questionnaire (HLQ). Using multiple logistic regression and hierarchical cluster analysis, we estimated the association between HLQ scale scores and the likelihood of long-term illness and multimorbidity, and identified socio-demographic and health characteristics related to profiles of health literacy strengths and weaknesses. Results An increase in ‘actively managing my health’ and ‘social support for health’ decreased the odds of having a long-term illness [odds ratio, OR 0.53 (0.31–0.9); OR 0.43 (0.24–0.74)] and multimorbidity [OR 0.51 (0.26–0.98); OR 0.33 (0.17–0.62)], respectively. Conversely, an increase in ‘healthcare provider support’ increased the odds of having long-term illness [OR 2.97 (1.78–5.08)] and multimorbidity [OR 2.94 (1.53–5.87)], respectively. Five profiles were identified based on the cluster analysis. Each cluster was characterized by specific health characteristics, e.g. Cluster A by better health status (χ2 = 39.976 (4), P < 0.001) and well-being (χ2 = 28.832 (4), P < 0.001) and Cluster D by poor health status (χ2 = 39.976 (4), P < 0.001) and increased likelihood of long-term illness (χ2 = 18.641 (4), P < 0.001). Conclusions The association of health literacy with long-term illness and multimorbidity in combination with the health literacy profiling based on cluster analysis provides a comprehensive needs assessment and a promising starting point for the development of health literacy responsive interventions.