Health literacy in rural and urban populations: A systematic review |
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| Affiliation: | 1. School of Commerce, and Centre for Health Research, University of Southern Queensland, QLD 4350, Australia;2. Toowoomba Hospital, Queensland Health, QLD 4350, Australia;3. Economics Discipline, Khulna University, Khulna 9208, Bangladesh;4. Institute for Resilient Regions, University of Southern Queensland, QLD 4350, Australia;5. Health Economics and Financing Research, International Centre for Diarrhoeal Disease Research, Dhaka 1212, Bangladesh;6. Bangladesh Institute of Development Studies, Dhaka 1206, Bangladesh;1. Cardiovascular Prevention and Rehabilitation Program, University Health Network, Toronto Rehabilitation Institute, Toronto, Canada;2. Physical Therapy Department, Federal University of Minas Gerais, Belo Horizonte, Brazil;1. Academic Unit of Primary Care and Population Sciences, University of Southampton, Southampton, UK;2. Richard Bright Renal Service, North Bristol National Health Service Trust, Bristol, UK;3. Department of Surgery, University of Cambridge, and National Institute for Health Research Cambridge Biomedical Research Centre, Cambridge, UK;4. Health Psychology Research Unit, Royal Holloway, University of London, London, UK;5. Warwick Medical School, University of Warwick, Warwick, UK;6. Belfast Health and Social Care Trust, Belfast, UK;7. National Health Service Blood and Transplant, Bristol, UK;8. Scottish Renal Registry, City, UK;9. Transplant Unit, Royal Infirmary of Edinburgh, Edinburgh, UK;10. Department of Renal Medicine, Freeman Hospital, Newcastle-upon Tyne, UK;1. NIHR Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance at Imperial College London, Hammersmith Campus, Du Cane Road, London W12 0NN, UK;2. National Taipei Hospital, Ministry of Health and Welfare, Taiwan, Taipei Medical University, Taipei, Taiwan;3. Department of Obstetrics and Gynaecology, Hospital Universitario de la Ribera, Alzira, Valencia, Spain;4. Academic Paediatric Hospital “Pedro Borrás”, Havana City, Cuba;1. University of East Anglia, School of Pharmacy, Norwich Research Park, Norwich, UK;2. School of Social Sciences and Psychology, University of Western Sydney, Sydney, Australia |
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| Abstract: | ObjectiveThis review assessed whether health literacy differences exist between rural and urban populations and whether rurality is a determinant.MethodsEight online databases were searched using the keywords “health literacy”, “rural” and “urban”, and related terms. Peer-reviewed original research comparing health literacy levels between rural and urban populations were evaluated for strength of evidence. A narrative synthesis summarised the results of included studies.ResultsNineteen articles met inclusion criteria and were of sufficient methodological quality for data extraction. The majority of studies found that urban populations had higher health literacy than rural populations. Differences were more likely to be found in developing than developed countries. Studies that performed covariate analysis indicated that rurality may not be a significant determinant of health literacy.ConclusionEvidence suggests that rurality alone does not explain rural-urban health literacy differences and that sociodemographic factors play important roles.Practice implicationsThese findings could be used to help inform the development of evidence-based interventions specifically for rural populations, at both health policy and clinical levels; for example, by tackling healthcare access challenges. The findings also provide a lens through which to consider efforts to reduce rural-urban health outcome disparities. |
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| Keywords: | Health literacy Rural Urban Health disparities Social determinants of health |
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