Health literacy and disparities in COVID-19–related knowledge, attitudes, beliefs and behaviours in Australia

Kirsten J. McCaffery*, Rachael H. Dodd, Erin Cvejic, Julie Ayre, Carys Batcup, Jennifer M.J. Isautier, Tessa Copp, Carissa Bonner, Kristen Pickles, Brooke Nickel, Thomas Dakin, Samuel Cornell, Michael S. Wolf

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

136 Scopus citations


Objectives: To explore the variation in understanding of, attitudes towards, and uptake of, health advice on coronavirus disease 2019 (COVID-19) during the 2020 pandemic stage 3 restrictions (‘lockdown’) by health literacy in the Australian population. Study design: National cross-sectional community survey. Setting: Australian general public. Participants: Adults aged over 18 years (N = 4362). Main outcome measures: Knowledge, attitudes and behaviours related to COVID-19; health literacy and sociodemographic factors. Results: People with inadequate health literacy had poorer understanding of COVID-19 symptoms (49% vs 68%; p < 0.001), were less able to identify behaviours to prevent infection (59% vs 72%; p < 0.001), and experienced more difficulty finding information and understanding government messaging about COVID-19 than people with adequate health literacy. People with inadequate health literacy were less likely to rate social distancing as important (6.1 vs 6.5; p < 0.001) and reported more difficulty with remembering and accessing medicines since lockdown (3.6 vs 2.7; p < 0.001). People with lower health literacy were also more likely to endorse misinformed beliefs about COVID-19 and vaccinations (in general) than those with adequate health literacy. The same pattern of results was observed among people who primarily speak a language other than English at home. Conclusion: Our findings show that there are important disparities in COVID-19–related knowledge, attitudes and behaviours according to people’s health literacy and language. These have the potential to undermine efforts to reduce viral transmission and may lead to social inequalities in health outcomes in Australia. People with the greatest burden of chronic disease are most disadvantaged, and are also most likely to experience severe disease and die from COVID-19. Addressing the health literacy, language and cultural needs of the community in public health messaging about COVID-19 must now be a priority in Australia.

Original languageEnglish (US)
Article number30342012
JournalPublic Health Research and Practice
Issue number4
StatePublished - Dec 2020

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health


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