ArticleEuropean journal of public health2023
Urban-rural differences in health literacy in the metropolitan area of Berlin, Germany, and its surroundings.
Article in European journal of public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 10 citations in OpenAlex.
- Trends in endometriosis hospitalizations in Germany, 2000-2023.BMC women's health · 2026Article
- Exploring the Interplay of Health Literacy and Non-Communicable Disease Health Outcomes in Southeast Asia: A Systematic Review.Iranian journal of public health · 2025Review
- Risk factors associated with health literacy among community residents in China based on multiple correspondence analysis and ordinal logistic regression.Scientific reports · 2025Article
- Assessing Health Literacy Among Hospitalized Patients: A Cross-Sectional Study in Silesia, Poland.Healthcare (Basel, Switzerland) · 2025Article
- Health literacy and quality of life of riverine populations in primary health care.Revista latino-americana de enfermagem · 2025Article
- Factors associated with functional health literacy and the quality of life of riverside residents served by the primary care network in the Brazilian amazon: a cross-sectional study.BMC primary care · 2024Article
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHealth literacy is gaining importance as it concerns the ability of individuals to encounter the complex demands of health in modern societies. Little is known about the environmental associations of health literacy in high-income countries. This study aims to (i) analyse urban-rural differences in health literacy and further (ii) investigate the interrelations of associated factors.
methodsBased on secondary analyses using a population-based survey of individuals aged 35 years and older from Berlin, Germany, and the surrounding rural area. Health literacy, sociodemographic factors (gender, age, educational level, marital status, income), environmental factors (urban/rural) and health behaviour (physical activity) were assessed with questionnaires. T-tests, Analyses of Variance and multiple regression with interaction terms have been applied.
resultsIn total, 1822 participants (51.2% female and 56.8% living in an urban region) took part in this study. Health literacy was significantly higher in rural regions (mean = 35.73, SD = 7.56) than in urban regions (mean = 34.10, SD = 8.07). Multiple multivariate regressions showed that living in urban regions, being older, having vocational or basic education, having mid or low income, being widowed, having moderate or low levels of physical activity were significantly negatively associated with health literacy. Incorporating interaction terms showed significance that being older is positively associated with urban regions.
conclusionWe found higher levels of health literacy in rural regions and also demonstrated that multiple associated factors of health literacy work congruously. Thus, the environment, associated factors and their interplay must be considered in future urban-rural health literacy research.
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