Gender differences in variables associated with poor health literacy in patients with pulmonary embolism: A cross-sectional study

Background So far, health literacy (HL) in patients with pulmonary embolism (PE) has received no attention. Thus, the study objective was to investigate the associations between HL and sociodemographic factors in women and men with PE. Materials and methods An online survey of insurees of a German health insurance company (age ≥18 years, ≥1 PE event in the past 2 years) was conducted in January 2022. From 3200 individuals who were contacted, 978 (65.8% male) were included in the analysis. The outcome HL was assessed using the Health Literacy Questionnaire (HLQ). Multivariable linear regression models stratified by gender were performed to investigate the associations between the nine subscales of the HLQ (dependent variables) and age-group, education level, marital status, current mental stress, history of mental disorder, heart failure and cancer (independent variables). Results The HLQ subscales "Feeling understood and supported by healthcare providers", "Ability to actively engage with healthcare providers", and "Navigating the healthcare system" were significantly better in men in comparison to women. Multivariable regression analyses showed that low educational status and younger age were significantly and independently associated with poor HL in most HLQ subscales in women, but not in men. Single or divorced family status was more often associated with poor HL in men compared with women. Current mental stress was negatively associated with HL in both genders. Conclusions Poorly educated and younger women with PE are a major risk group of poor HL, as well as men who are single or divorced. These results suggest that interventions to improve HL should be gender-specific.