ArticlePloS one2019
Health literacy as a mediator of the relationship between socioeconomic status and health: A cross-sectional study in a population-based sample in Florence.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 102 papers, 2 of them syntheses that pooled it.
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Who cites it
102 citing papers in PubMed, 2 syntheses or guidelines pooled it, 185 citations in OpenAlex.
- Interventions Addressing Health Literacy in Cancer Care: A Systematic Review of Reviews.International journal of environmental research and public health · 2025Pooled it
- Employment Status and Alcohol-Attributable Mortality Risk-A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2022Pooled it
- Comprehension of an artificial intelligence-generated discharge letter versus a traditional discharge letter: two controlled quasi-experimental parallel-group studies.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2026Article
- Is educational expansion beneficial for health? A counterfactual mediation analysis of its impact on trends of daily activity limitations among different age groups in Germany.Archives of public health = Archives belges de sante publique · 2026Article
- Mental health literacy mediates associations of self rated health and chronic disease status with anxiety and depression in Chinese residents.Scientific reports · 2026Article
- The relationship between economic status, poverty, and health among Arabs in Israel.Israel journal of health policy research · 2026Article
- Health Literacy and Mental Health in Adolescents: Parental and Self-Reported Cross-Sectional Data in a Bilingual Region.Healthcare (Basel, Switzerland) · 2026Article
- Observational
- Supervised machine learning model to predict total knee replacement in a large osteoartrhitis real-world evidence dataset using retrospectively 20-year insurance data from Israel.BMC medical informatics and decision making · 2026Article
- Predictors of exercise participation among Saudi adults attending primary healthcare centers in Riyadh.Scientific reports · 2026Article
- Income-related Inequalities in Cancer Screening Among Korean Adults Aged 40 and Above: A Cross-sectional Analysis of the Age-varying Mediation of Health Literacy.Journal of preventive medicine and public health = Yebang Uihakhoe chi · 2026Article
- Food Allergy Diagnosis in Early Childhood: Journey Mapping Study With Parents and Pediatricians.Clinical and translational allergy · 2026Article
- Exploring the factors associated with health literacy among adolescents in Hong Kong.Scientific reports · 2026Article
- Socio-ecological factors of health literacy and physical activity among middle-aged and older Chinese adults.Frontiers in public health · 2026Article
- Article
- Examining maternal health literacy as a mediator of the relationship between social vulnerability and caregiving practices for improving infant development.BMC public health · 2025Article
- Article
- Socioeconomic gradients and mechanisms of chronic disease health literacy: the mediating role of preventive healthcare utilization in rural Shangdong, China.International journal for equity in health · 2025Article
- Socioeconomic Status, Voice Disorder Risk, and Voice-Related Handicap Across Childhood.JAMA otolaryngology-- head & neck surgery · 2025Article
- Sociodemographic disparities in health literacy among American adults: A national survey study.Preventive medicine reports · 2025Article
42 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHealth literacy(HL) has recently been proposed as a potential mediator in the pathway through which socio-economic status(SES) affects health. However, empirical research investigating the contribution of HL in this relationship remains scarce. This study investigated whether functional HL mediates the association between SES and self-reported health(SRH) in an adult population-based sample.
methodsThe study adopted a cross-sectional design. Education level and financial status were used as measures of SES, while functional HL was assessed with the Newest Vital Sign. Moderated mediation analyses were conducted using SES variables as independent variables, SRH as dependent variable and functional HL as mediator variable. Furthermore, age, sex and chronic diseases were tested as moderators of the effect mediated by functional HL.
results452 subjects completed the study (58,8% female; mean age 53,25±11,7). Results showed that functional HL mediates on average 18.5% of the association between education and SRH (p = 0.02) and 12.9% (p = 0.01) of the association between financial status and SRH. Furthermore, the proportion of effect mediated by functional HL was found to be higher in lower socio-economic classes for both SES variables considered. No significant moderation effects of age, sex or chronic diseases were observed for both SES variables.
conclusionFindings suggest that functional HL may serve as a pathway by which SES affects health status, especially in lower SES groups. HL may be a valuable and actionable intermediate target for addressing health inequalities. However, further studies are needed to better define the mediating role of HL across socio-economic classes.
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