{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T20:22:17Z","timestamp":1778617337601,"version":"3.51.4"},"reference-count":60,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2021,2,26]],"date-time":"2021-02-26T00:00:00Z","timestamp":1614297600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The Blacktown-Mt Druitt Health Medical Staff Council","award":["P00026796"],"award-info":[{"award-number":["P00026796"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Evidence shows that inadequate or low health literacy (LHL) levels are significantly associated with economic ramifications at the individual, employer, and health care system levels. Therefore, this study aims to estimate the economic burden of LHL among a culturally and linguistically diverse (CALD) community in Blacktown: a local government area (LGA) in Sydney, Australia. This study is a secondary analysis of cross-sectional data from publicly available datasets, including 2011 and 2016 census data and National Health Survey (NHS) data (2017\u20132018) from the Australian Bureau of Statistics (ABS), and figures on Disease Expenditure in Australia for 2015\u20132016 provided by the Australian Institute of Health and Welfare (AIHW). This study found that 20% of Blacktown residents reported low levels of active engagement with health care providers (Domain 6 of the Health Literacy Questionnaire (HLQ)), with 14% reporting a limited understanding of the health information required to take action towards improving health or making health care decisions (Domain 9 of the HLQ). The overall extra\/delta cost (direct and indirect health care costs) associated with LHL in the Blacktown LGA was estimated to be between $11,785,528 and $15,432,239 in 2020. This is projected to increase to between $18,922,844 and $24,191,911 in 2030. Additionally, the extra disability-adjusted life year (DALY) value in 2020, for all chronic diseases and age-groups\u2014comprising the extra costs incurred due to years of life lost (YLL) and years lived with disability (YLD)\u2014was estimated at $414,231,335. The findings of our study may enable policymakers to have a deeper understanding of the economic burden of LHL in terms of its impact on the health care system and the production economy.<\/jats:p>","DOI":"10.3390\/ijerph18052303","type":"journal-article","created":{"date-parts":[[2021,2,26]],"date-time":"2021-02-26T06:47:20Z","timestamp":1614322040000},"page":"2303","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Estimating the Economic Burden of Low Health Literacy in the Blacktown Community in Sydney, Australia: A Population-Based Study"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3153-5652","authenticated-orcid":false,"given":"Wadad Kathy","family":"Tannous","sequence":"first","affiliation":[{"name":"School of Business, Western Sydney University, Parramatta, NSW 2150, Australia"},{"name":"Translational Health Research Institute, Western Sydney University, Campbelltown, NSW 2560, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1733-5216","authenticated-orcid":false,"given":"Moin Uddin","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Translational Health Research Institute, Western Sydney University, Campbelltown, NSW 2560, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James Rufus","family":"John","sequence":"additional","affiliation":[{"name":"Translational Health Research Institute, Western Sydney University, Campbelltown, NSW 2560, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Graham","family":"Reece","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Blacktown Hospital, Blacktown, NSW 2148, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0026-1457","authenticated-orcid":false,"given":"Golo","family":"Ahlenstiel","sequence":"additional","affiliation":[{"name":"School of Medicine, Western Sydney University, Penrith, NSW 2751, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,2,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.colegn.2017.02.005","article-title":"Patient-centred care as an approach to improving health care in Australia","volume":"25","author":"Delaney","year":"2018","journal-title":"Collegian"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/s40900-017-0067-x","article-title":"Recruiting patients as partners in health research: A qualitative descriptive study","volume":"3","author":"Vat","year":"2017","journal-title":"Res. 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