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Comprehensive health literacy in Japan is lower than in Europe: a validated Japanese-language assessment of health literacy

Overview of attention for article published in BMC Public Health, May 2015
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (91st percentile)

Mentioned by

31 tweeters


90 Dimensions

Readers on

186 Mendeley
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Comprehensive health literacy in Japan is lower than in Europe: a validated Japanese-language assessment of health literacy
Published in
BMC Public Health, May 2015
DOI 10.1186/s12889-015-1835-x
Pubmed ID

Kazuhiro Nakayama, Wakako Osaka, Taisuke Togari, Hirono Ishikawa, Yuki Yonekura, Ai Sekido, Masayoshi Matsumoto


Health literacy, or the ability to access, understand, appraise and apply health information, is central to individuals' health and well-being. A comprehensive, concept-based measure of most dimensions of health literacy has been developed for the general population in Europe, which enables comparisons within and between countries. This study seeks to validate this tool for use in Japan, and to use a Japanese translation to compare health literacy levels in Japan and Europe. A total of 1054 Japanese adults recruited through an Internet research service company, completed a Japanese-language version of the 47-item European Health Literacy Survey Questionnaire (HLS-EU-Q47). The survey was administered via an online questionnaire, and participant demographics were closely matched to those of the most recent Japanese national census. Survey results were compared with those previously reported in an eight-country European study of health literacy. Internal consistency for the translated questionnaire was valid across multiple metrics. Construct validity was checked using confirmatory factor analyses. The questionnaire correlated well with existing scales measuring health literacy and mental health status. In general, health literacy in the Japanese population was lower than in Europe, with Japanese respondents rating all test items as more difficult than European respondents. The largest difference (51.5 %) was in the number of respondents finding it difficult to know where to get professional help when they are ill. This study translated a comprehensive health literacy questionnaire into Japanese and confirmed its reliability and validity. Comparative results suggest that Japanese health literacy is lower than that of Europeans. This discrepancy may be partly caused by inefficiency in the Japanese primary health care system. It is also difficult to access reliable and understandable health information in Japan, as there is no comprehensive national online platform. Japanese respondents found it more difficult to judge and apply health information, which suggests that there are difficulties in health decision-making in Japan. Numerous issues may be linked to lower levels health literacy in Japan, and further studies are needed to improve this by developing individual competencies and building supportive environments.

Twitter Demographics

The data shown below were collected from the profiles of 31 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 186 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Japan 2 1%
Indonesia 1 <1%
Portugal 1 <1%
Brazil 1 <1%
Unknown 181 97%

Demographic breakdown

Readers by professional status Count As %
Student > Master 34 18%
Researcher 26 14%
Student > Ph. D. Student 22 12%
Student > Bachelor 19 10%
Student > Doctoral Student 14 8%
Other 48 26%
Unknown 23 12%
Readers by discipline Count As %
Medicine and Dentistry 61 33%
Nursing and Health Professions 37 20%
Psychology 13 7%
Social Sciences 12 6%
Arts and Humanities 5 3%
Other 21 11%
Unknown 37 20%

Attention Score in Context

This research output has an Altmetric Attention Score of 19. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 June 2020.
All research outputs
of 16,238,899 outputs
Outputs from BMC Public Health
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Outputs of similar age
of 237,163 outputs
Outputs of similar age from BMC Public Health
of 2 outputs
Altmetric has tracked 16,238,899 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 93rd percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 11,167 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 12.1. This one has done well, scoring higher than 88% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 237,163 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 91% of its contemporaries.
We're also able to compare this research output to 2 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them