Self-perceived and calculated health literacy score in long-term unemployed people

INTRODUCTION: Recent studies show that low levels of health literacy are widespread in Germany, especially among socioeconomically disadvantaged groups such as long-term unemployed individuals. At the same time, it is unclear to what extent commonly used health literacy tools are tailored to the needs and literacy skills of socioeconomically disadvantaged populations. Therefore, we examined to what extent self-perceived and calculated health literacy scores of long-term unemployed people in Germany correlate. METHODS: We conducted 171 semi-structured interviews between November 2022 and February 2023 with long-term unemployed people in 11 occupational reintegration settings in Bremen, Germany. Health literacy was measured by the HLS-EU-Q16 (self-report health literacy score) and the Newest Vital Sign (calculated health literacy score). Descriptive and correlation analyses were performed with R. RESULTS: According to HLS-EU-Q16, 37% of the 171 participants (male=112, female=59) had sufficient health literacy, according to NVS only 29%. An inadequate health literacy score was shown by 19% according to HLS-EU-Q16, and by 48% according to NVS. The applied tools did not show a statistically significant correlation (r = 0.105, p = 0.17). CONCLUSIONS: Self-reported health literacy data (e.g., measured by the HLS-EU-Q16) could underestimate deficits in health literacy and may be insufficient as a sole assessment tool to determine health literacy among low-literate populations as long-term unemployed people. KEY MESSAGES: • Various tools exist to measure health literacy. Not all measures might be suitable for all population groups. Literate skills should be considered while applying different health literacy measures. • More health literacy data on low-literate populations is needed in the literature. Health literacy tools applied in these population groups should be short and easy to understand.