Health literacy, multimorbidity and its effect on mental health in South African adults

A repeated cross-sectional nationally representative panel study

Bibliographic Data

ID22071202
AuthorsAshleigh Craig (0000-0002-7641-5953, South African Medical Research Council, corresponding author), Khuthala Mabetha (0000-0002-7233-5913, University of the Witwatersrand), Olatundun Gafari (0000-0003-3416-5084, University Hospital Southampton NHS Foundation Trust), Shane A Norri (0000-0001-7124-3788, South African Medical Research Council), S A Norris
Year2025
Volume13
Pages1622005-1622005
Publication date2025-08-20
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2025.1622005
PMID40910040
OpenAlexW4413343207
LanguageEN
References cited28

Objective and methods: Health literacy is a key determinant of physical and mental health outcomes, particularly in low- and middle-income settings like South Africa, where multimorbidity is increasingly common. Limited health literacy may hinder effective management of multiple chronic conditions and worsen mental health. Using repeated cross-sectional nationally representative data, this study examined the relationship between health literacy and multimorbidity, with a specific focus on mental health among South African adults (18 years and older). Results: Most respondents had minimal depression risk, with 21.7% showing probable depression, lower than the 25.7 and 26.2% in Panels 1 (2021) and 2 (2022) respectively. In efforts to further corroborate the odds of having mental or physical health risk with higher levels of ACE exposure, our results confirmed the increased likelihood of depression, anxiety and multimorbidity with increased odds of early adversity, irrespective of differing socio-demographics. The results further revealed that socioeconomic status directly influenced depression, which was partially mediated via health literacy. Additionally, the association between socioeconomic status and multimorbidity was fully mediated by ACE exposure and depression. Conclusion: One in five South Africans experience depressive symptoms, with notable regional differences. Childhood adversity contributes to increased mental health risk and higher multimorbidity. Health literacy was found to influence the link between socioeconomic status and depression, suggesting that lower literacy increases vulnerability. These findings therefore emphasize the need for targeted interventions to address childhood adversity, improve health literacy, and enhance mental health resources across South Africa

Cross-sectional study · Environmental health · Health care · Health literacy · Literacy · Logistic regression · Mental health · Mental health literacy · Mental illness · Odds · Population · Psychiatry · Psychological intervention · Socioeconomic status · Chronic Disease Management Strategies · Health Literacy and Information Accessibility · Medicine · Mental Health Treatment and Access · Psychology · Gerontology

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