Health literacy among individuals with type 2 diabetes in France: greater social inequalities among women; the Entred 3 study

Abstract Aim The aim of this study was to describe and explore the health literacy in people living with type 2 diabetes in mainland France and its association with socioeconomic factors. Methods ENTRED 3 is a nationally representative French diabetes population-based survey conducted in 2019. Healt...

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Main Authors: Roxane Agius, Xavier Debussche, Henri Panjo, Sandrine Fosse-Edorh, Laurent Rigal
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-22118-3
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author Roxane Agius
Xavier Debussche
Henri Panjo
Sandrine Fosse-Edorh
Laurent Rigal
author_facet Roxane Agius
Xavier Debussche
Henri Panjo
Sandrine Fosse-Edorh
Laurent Rigal
author_sort Roxane Agius
collection DOAJ
description Abstract Aim The aim of this study was to describe and explore the health literacy in people living with type 2 diabetes in mainland France and its association with socioeconomic factors. Methods ENTRED 3 is a nationally representative French diabetes population-based survey conducted in 2019. Health literacy was measured using two scales from the Health Literacy Questionnaire: ability to actively engage with healthcare providers (HLQ6) and sufficient understanding of health information to know what to do (HLQ9). Gender-stratified analyses and multivariate linear regressions were conducted to study health literacy according to education level and country of birth, adjusting for age and antidiabetic treatment. These analyses were weighted to account for the study’s complex sampling design and non-response bias. Results Two thousand seven hundred fourteen people living with type 2 diabetes responded to the ENTRED 3 questionnaire. The mean scores for respectively HLQ6 and HLQ9 were significantly higher among men (4.03 (standard error of mean sem 0.02); 4.16 (sem 0.03)) than among women (3.87 (sem 0.01); 3.98 (sem 0.05)). At comparable age and antidiabetic treatment: i) education level were positively associated with HLQ6 and HLQ9 among men; ii) women born in North Africa had lower HLQ6 and faced more pronounced educational inequalities with regards to HLQ9 than women born in France. Conclusion This study provides a reference for health literacy in persons living with type 2 diabetes in France and identifies a link between health literacy and socioeconomic factors. Its results represent a significant step in the understanding of the mechanisms of social inequalities in health in France.
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spelling doaj-art-6eeef9151dfa475d91423068c4ce4ac92025-08-20T03:10:13ZengBMCBMC Public Health1471-24582025-03-0125111310.1186/s12889-025-22118-3Health literacy among individuals with type 2 diabetes in France: greater social inequalities among women; the Entred 3 studyRoxane Agius0Xavier Debussche1Henri Panjo2Sandrine Fosse-Edorh3Laurent Rigal4Department of Non-Communicable Diseases and Trauma, Santé publique France, SpFrance, F-94415Wound and healing Expert Center, Centre Hospitalier Saint-Brieuc Paimpol Tréguier CESP, INSERM, UVSQ, Paris-Saclay UniversityDepartment of Non-Communicable Diseases and Trauma, Santé publique France, SpFrance, F-94415 CESP, INSERM, UVSQ, Paris-Saclay UniversityAbstract Aim The aim of this study was to describe and explore the health literacy in people living with type 2 diabetes in mainland France and its association with socioeconomic factors. Methods ENTRED 3 is a nationally representative French diabetes population-based survey conducted in 2019. Health literacy was measured using two scales from the Health Literacy Questionnaire: ability to actively engage with healthcare providers (HLQ6) and sufficient understanding of health information to know what to do (HLQ9). Gender-stratified analyses and multivariate linear regressions were conducted to study health literacy according to education level and country of birth, adjusting for age and antidiabetic treatment. These analyses were weighted to account for the study’s complex sampling design and non-response bias. Results Two thousand seven hundred fourteen people living with type 2 diabetes responded to the ENTRED 3 questionnaire. The mean scores for respectively HLQ6 and HLQ9 were significantly higher among men (4.03 (standard error of mean sem 0.02); 4.16 (sem 0.03)) than among women (3.87 (sem 0.01); 3.98 (sem 0.05)). At comparable age and antidiabetic treatment: i) education level were positively associated with HLQ6 and HLQ9 among men; ii) women born in North Africa had lower HLQ6 and faced more pronounced educational inequalities with regards to HLQ9 than women born in France. Conclusion This study provides a reference for health literacy in persons living with type 2 diabetes in France and identifies a link between health literacy and socioeconomic factors. Its results represent a significant step in the understanding of the mechanisms of social inequalities in health in France.https://doi.org/10.1186/s12889-025-22118-3Health literacyType 2 diabetesSocial inequalities in healthMigration
spellingShingle Roxane Agius
Xavier Debussche
Henri Panjo
Sandrine Fosse-Edorh
Laurent Rigal
Health literacy among individuals with type 2 diabetes in France: greater social inequalities among women; the Entred 3 study
BMC Public Health
Health literacy
Type 2 diabetes
Social inequalities in health
Migration
title Health literacy among individuals with type 2 diabetes in France: greater social inequalities among women; the Entred 3 study
title_full Health literacy among individuals with type 2 diabetes in France: greater social inequalities among women; the Entred 3 study
title_fullStr Health literacy among individuals with type 2 diabetes in France: greater social inequalities among women; the Entred 3 study
title_full_unstemmed Health literacy among individuals with type 2 diabetes in France: greater social inequalities among women; the Entred 3 study
title_short Health literacy among individuals with type 2 diabetes in France: greater social inequalities among women; the Entred 3 study
title_sort health literacy among individuals with type 2 diabetes in france greater social inequalities among women the entred 3 study
topic Health literacy
Type 2 diabetes
Social inequalities in health
Migration
url https://doi.org/10.1186/s12889-025-22118-3
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