Health literacy as a determinant, mediator and/or moderator of health: empirical models using the European Health Literacy Survey dataset.

Background/research Question:: In the health literacy (HL) discourse there is debate about the ways by which HL is impacting health. Three different, logically non-exclusive hypotheses are proposed: (a) HL as a specific, direct, social determinant of health; (b) HL as a mediator between other determinants and health; and (c) HL as a moderator of the effect of other determinants on health. Only few examples of empirically testing the mediator or moderator hypothesis exist.