Study
Human FactorsNew This WeekStrong effect

Low health literacy is linked to socioeconomic status and age

Individuals with lower socioeconomic status and older age are more likely to have inadequate or problematic health literacy.

Quality & Quantity · 2025

01

Key Findings

  • 01Inadequate or problematic health literacy was significantly associated with advanced age.
  • 02Low income was significantly associated with inadequate or problematic health literacy.
  • 03Limited educational attainment was significantly associated with inadequate or problematic health literacy.
  • 04Poor self-perceived health was significantly associated with inadequate or problematic health literacy.
  • 05Limitations in activities of daily living were significantly associated with inadequate or problematic health literacy.
02

Application

Design takeaway

When designing for health-related contexts, simplify complex information and ensure it is accessible to individuals with lower health literacy, particularly those who are older or have lower socioeconomic status.

How to apply

When developing health information materials, use plain language, visual aids, and consider multiple formats to cater to different literacy levels. Test designs with diverse user groups to ensure comprehension.

Project actions

  • 01When researching user needs, consider asking about their confidence in understanding health information.
  • 02If your design involves health information, think about how to make it easier for people with lower health literacy to use.
03

Method & Evidence

AimTo investigate the prevalence of inadequate or problematic health literacy among university students and their families and analyze its association with socioeconomic and health status determinants.
MethodQuantitative survey research
ProcedureThe study adapted the HL-EU-Q47 instrument to measure functional, interactive, and critical health literacy. The questionnaire, comprising 47 items on a Likert scale, was administered via Paper Assisted Personal Interview (PAPI) to assess participants' ability to obtain, understand, evaluate, and apply health information across healthcare, disease prevention, and health promotion domains. Logistic regression was used to identify risk factors.
ContextUniversity students and their families in the Republic of San Marino

Variables

IV["Socioeconomic status (income, education)","Age","Self-perceived health status","Limitations in activities of daily living"]
DV["Health literacy (functional, interactive, critical)"]
CV["Geographical context (Republic of San Marino)","Family context"]
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Strengths & Limitations

Strengths

  • +Adaptation of a validated instrument (HL-EU-Q47).
  • +Use of logistic regression to identify risk factors.

Limitations

This study focused on a specific population in San Marino, so the results might not apply everywhere. The study also relied on self-reported data, which can sometimes be inaccurate.

Reliability & validity

The study adapted a validated instrument (HL-EU-Q47), suggesting good internal validity. The use of PAPI interviews may enhance reliability by standardizing administration. However, the generalizability of findings (external validity) might be limited by the specific context.

Think critically

How might the design of a digital health application need to differ for users with high versus low health literacy?

05

Design Principles

"Design for clarity and accessibility, recognizing that users have diverse cognitive and informational needs."

Understanding these associations is crucial for designing effective health communication strategies and interventions. It allows for targeted approaches that consider the diverse needs and capabilities of different user groups.

06

What This Means for Your Design

People who are older, poorer, or have less education often find it harder to understand health information.

How to use in your project

  • 1.You can use this research to justify why you chose specific design strategies to improve the clarity and accessibility of your health-related design project.
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Add to My Project

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Quick Cite

(2025). Health literacy among university students and their families in the Republic of San Marino: association with socioeconomic and health status determinants. Quality & Quantity. https://doi.org/10.1007/s11135-025-02343-z Retrieved from https://designdex.org/study/1e747524-f197-4f57-9f02-041a75cb2119/low-health-literacy-is-linked-to-socioeconomic-status-and-age

Paragraph starter

Research indicates a strong association between lower socioeconomic status, advanced age, and reduced health literacy. This suggests that design interventions aimed at health information should prioritize clear, accessible language and formats, particularly for older demographics and those with limited educational or financial resources, to ensure equitable understanding and engagement.

09

Source

Quality & Quantity

Health literacy among university students and their families in the Republic of San Marino: association with socioeconomic and health status determinants

journal · 2025

View source

Questions about this research

What does the research say about low health literacy is linked to socioeconomic status and age?
When designing for health-related contexts, simplify complex information and ensure it is accessible to individuals with lower health literacy, particularly those who are older or have lower socioeconomic status. Evidence: Quality & Quantity (2025).
Why does "Low health literacy is linked to socioeconomic status and age" matter for design?
Understanding these associations is crucial for designing effective health communication strategies and interventions. It allows for targeted approaches that consider the diverse needs and capabilities of different user groups.
How can designers apply this research?
When designing for health-related contexts, simplify complex information and ensure it is accessible to individuals with lower health literacy, particularly those who are older or have lower socioeconomic status.
What were the main findings?
Inadequate or problematic health literacy was significantly associated with advanced age.. Low income was significantly associated with inadequate or problematic health literacy.. Limited educational attainment was significantly associated with inadequate or problematic health literacy.. Poor self-perceived health was significantly associated with inadequate or problematic health literacy.
What research method was used?
Quantitative survey research.
How strong is the evidence?
Evidence strength is rated Strong effect, based on a 2025 journal from Quality & Quantity.
What should I do differently in my next project?
When developing health information materials, use plain language, visual aids, and consider multiple formats to cater to different literacy levels. Test designs with diverse user groups to ensure comprehension.
What are the limitations?
The study was conducted in a specific geographical context (Republic of San Marino), which may limit the generalizability of findings to other populations. The reliance on self-reported data for health status and socioeconomic factors could introduce bias.
Is there evidence that health affects design outcomes?
The research found that older individuals, those with lower incomes, less education, poorer self-reported health, and difficulties with daily activities are more likely to struggle with understanding and using health information. Understanding these associations is crucial for designing effective health communication s Source: Quality & Quantity (2025).
Where does this health literacy research apply?
University students and their families in the Republic of San Marino It sits within human factors research on designdex.org.

Related research topics

health design research · evidence on health · does health improve design outcomes · health literacy studies for designers · health and health literacy findings · human factors research evidence