Dataset Information

The Relationship between Health Literacy and Health Disparities: A Systematic Review.

ABSTRACT:

Objectives

Health literacy is commonly associated with many of the antecedents of health disparities. Yet the precise nature of the relationship between health literacy and disparities remains unclear. A systematic review was conducted to better understand in how far the relationship between health literacy and health disparities has been systematically studied and which potential relationships and pathways have been identified.

Methods

Five databases, including PubMed/MEDLINE and CINAHL, were searched for peer-reviewed studies. Publications were included in the review when they (1) included a valid measure of health literacy, (2) explicitly conceived a health disparity as related to a social disparity, such as race/ethnicity or education and (3) when results were presented by comparing two or more groups afflicted by a social disparity investigating the effect of health literacy on health outcomes. Two reviewers evaluated each study for inclusion and abstracted relevant information. Findings were ordered according to the disparities identified and the role of health literacy in explaining them.

Results

36 studies were included in the final synthesis. Most of the studies investigated racial/ethnic disparities, followed by some few studies that systematically investigated educational disparities. Some evidence was found on the mediating function of health literacy on self-rated health status across racial/ethnic and educational disparities, as well as on the potential effect of health literacy and numeracy on reducing racial/ethnic disparities in medication adherence and understanding of medication intake.

Conclusion

Overall the evidence on the relationship between health literacy and disparities is still mixed and fairly limited. Studies largely varied with regard to health(-related) outcomes under investigation and the health literacy assessments used. Further, many studies lacked a specific description of the nature of the disparity that was explored and a clear account of possible pathways tested.

SUBMITTER: Mantwill S

PROVIDER: S-EPMC4689381 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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Publications

The Relationship between Health Literacy and Health Disparities: A Systematic Review.

Mantwill Sarah S Monestel-Umaña Silvia S Schulz Peter J PJ

PloS one 20151223 12

<h4>Objectives</h4>Health literacy is commonly associated with many of the antecedents of health disparities. Yet the precise nature of the relationship between health literacy and disparities remains unclear. A systematic review was conducted to better understand in how far the relationship between health literacy and health disparities has been systematically studied and which potential relationships and pathways have been identified.<h4>Methods</h4>Five databases, including PubMed/MEDLINE and ...[more]

PMID: 26698310

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Project description:BackgroundLow health literacy is considered a potential barrier to improving health outcomes in people with diabetes and other chronic conditions, although the evidence has not been previously systematically reviewed.ObjectiveTo identify, appraise, and synthesize research evidence on the relationships between health literacy (functional, interactive, and critical) or numeracy and health outcomes (i.e., knowledge, behavioral and clinical) in people with diabetes.MethodsEnglish-language articles that addressed the relationship between health literacy or numeracy and at least one health outcome in people with diabetes were identified by two reviewers through searching six scientific databases, and hand-searching journals and reference lists.FindingsSeven hundred twenty-three citations were identified and screened, 196 were considered, and 34 publications reporting data from 24 studies met the inclusion criteria and were included in this review. Consistent and sufficient evidence showed a positive association between health literacy and diabetes knowledge (eight studies). There was a lack of consistent evidence on the relationship between health literacy or numeracy and clinical outcomes, e.g., A1C (13 studies), self-reported complications (two studies), and achievement of clinical goals (one study); behavioral outcomes, e.g., self-monitoring of blood glucose (one study), self-efficacy (five studies); or patient-provider interactions (i.e., patient-physician communication, information exchange, decision-making, and trust), and other outcomes. The majority of the studies were from US primary care setting (87.5 %), and there were no randomized or other trials to improve health literacy.ConclusionsLow health literacy is consistently associated with poorer diabetes knowledge. However, there is little sufficient or consistent evidence suggesting that it is independently associated with processes or outcomes of diabetes-related care. Based on these findings, it may be premature to routinely screen for low health literacy as a means for improving diabetes-related health-related outcomes.

Project description:BackgroundHealth literacy is a multidimensional concept that is considered a primary public health concern. This concept is often neglected in research, and the evidence regarding health literacy in college students is limited. The aim of this study was two-fold: to determine the needs and limitations of health literacy among college students and to explore the relationships among the nine dimensions of health literacy and sociodemographic factors, including age, gender, nationality, year of study, field of study, smoking status, history of chronic diseases, use of on-campus gym, and the intention to exercise on-campus.MethodsThis study was conducted using a cross-sectional approach. A total of 520 college students participated in this study. The average age was 21.03 years (SD = 2.29), with 47.5% males and 52.5% females. Data were collected using a demographics questionnaire and the Health Literacy Questionnaire (HLQ). In addition to descriptive statistics, multivariate analysis of variance (MANOVA) and follow-up analyses were performed to explore any statistically significant mean differences among levels of health literacy and sociodemographic factors.ResultsThe levels of health literacy on the nine HLQ scales were lower than the levels reported in the literature. Multivariate analysis showed a significant effect of age, gender, smoking status, year of study, and field of study on the level of health literacy. Follow-up analyses revealed that female students, students from the health-related faculties, and those who do not smoke have higher levels of health literacy compared to their counterparts. A detailed comparison between the levels of the HLQ scales was made based on students' demographic characteristics. The field of study had the most prominent effect on the level of college students' health literacy; mean differences were statistically significant (p < .001), and effect sizes were large (ranging from .66 to 1.35 for the nine scales of the HLQ).ConclusionCollege students' health literacy is influenced by demographic characteristics. Such variations could amplify some of the existing health disparities. The implications of the findings on health, health promotion, and interprofessional education are discussed.

Project description:BackgroundGiven increasing numbers of people experiencing transitions in health insurance due to declines in employer-sponsored insurance and changes in health policy, the understanding and application of health insurance terms and concepts (health insurance literacy) may be important for navigating use of health care. The study objective was to systematically review evidence on the relationship between health insurance literacy and health care utilization.MethodsMedline, SCOPUS, Web of Science, CINAHL, PsychInfo, Cochrane Library, and reference lists of published literature were searched in August 2019. Quantitative, qualitative, and intervention studies that assessed the association of health insurance literacy as the exposure and health care utilization as the outcome were identified, without language or date restrictions. Outcomes were independently assessed by 2-3 reviewers.ResultsTwenty-one studies including a total of 62,416 subjects met inclusion criteria: three interventional trials, two mixed-methods studies, and sixteen cross-sectional studies. Ten of thirteen preventive care studies suggested that higher health insurance literacy was associated with greater utilization of primary care and other preventive services. Eight of nine studies of care avoidance demonstrated that individuals with lower health insurance literacy were more likely to delay or avoid care. A few studies had mixed results regarding the utilization of emergency department, inpatient, and surgical care.DiscussionThe emerging literature in this area suggests that health insurance literacy is an important factor that can enable effective utilization of health care, including primary care and preventive services. However, the literature is limited by a paucity of studies using validated tools that broadly measure health insurance literacy (rather than testing knowledge of specific covered services). Improving health insurance literacy of the general public and increasing plain language communication of health insurance plan features at the point of health care navigation may encourage more effective and cost-conscious utilization.

Dataset Information

The Relationship between Health Literacy and Health Disparities: A Systematic Review.

Objectives

Methods

Results

Conclusion

Publications

The Relationship between Health Literacy and Health Disparities: A Systematic Review.

Similar Datasets

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