Health Literacy in African-American Communities: Barriers and Strategies

Muvuka, Baraka; Combs, Ryan; Ayangeakaa, Suur D; Ali, Nida; Wendel, Monica L.; Jackson, Trinidad

doi:10.3928/24748307-20200617-01

Cited by 66 publications

(70 citation statements)

References 43 publications

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“…People who mistrust the health care system may be less likely to adhere to recommendations when those recommendations come from sources they do not trust, particularly if those recommendations are unclear and inconsistent. In a recent HLRP: Health Literacy Research and Practice article, Muvuka et al ( 2020 ) discuss how discriminatory practices and a paucity of appropriate and culturally targeted health information have limited African Americans access to health information that is understandable and trustworthy.…”

mentioning

confidence: 99%

Disparities in Adherence to COVID-19 Public Health Recommendations

Weiss¹,

Paasche‐Orlow²

2020

HLRP: Health Literacy Research and Practice

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mentioning

confidence: 99%

Disparities in Adherence to COVID-19 Public Health Recommendations

Weiss¹,

Paasche‐Orlow²

2020

HLRP: Health Literacy Research and Practice

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“…A 2017 study demonstrated that insured individuals among the most socially disadvantaged cancer survivors are less likely to receive cancer‐directed surgery compared to the least socially disadvantaged survivors 50 . Additionally, lower health literacy may adversely affect the healthcare utilization by minorities 51 . It is well established that historic discriminations, limited access to education, racism, and cultural insensitivity have hampered the ability of African American population to adequately acquire and interpret health information, affecting their ability to utilize needed healthcare 51 …”

Section: Discussionmentioning

confidence: 99%

Health services utilization, out‐of‐pocket expenditure, and underinsurance among insured non‐elderly cancer survivors in the United States, 2011–2015

et al. 2021

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Background High out‐of‐pocket (OOP) expenditure and inadequate insurance coverage may adversely affect cancer survivors. We aimed to characterize the extent and correlates of healthcare utilization, OOP expenditures, and underinsurance among insured cancer survivors. Methods We used 2011–2015 Medical Expenditure Panel Survey data to identify a nationally representative sample of insured non‐elderly adult (age 18–64 years) cancer survivors. We used negative binomial, two‐part (logistic and Generalized Linear Model with log link and gamma distribution), and logistic regression models to quantify healthcare utilization, OOP expenditures, and underinsurance, respectively, and identified sociodemographic correlates for each outcome. Results We identified 2738 insured non‐elderly cancer survivors. Adjusted average utilization of ambulatory, non‐ambulatory, prescription medication, and dental services was 14.4, 0.51, 24.9, and 1.4 events per person per year, respectively. Higher ambulatory and dental services utilization were observed in older adults, females, non‐Hispanic Whites, survivors with a college degree and high income, compared to their counterparts. Nearly all (97.7%) survivors had some OOP expenditures, with a mean adjusted OOP expenditure of $1552 per person per year. Adjusted mean OOP expenditures for ambulatory, non‐ambulatory, prescription medication, dental, and other health services were $653, $161, $428, $194, and $83, respectively. Sociodemographic variations in service‐specific OOP expenditures were generally consistent with respective utilization patterns. Overall, 8.8% of the survivors were underinsured. Conclusion Many insured non‐elderly cancer survivors allocate a substantial portion of their OOP expenditure for healthcare‐related services and experience financial vulnerability, resulting in nearly 8.8% of the survivors being underinsured. Utilization of healthcare services varies across sociodemographic groups.

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“…Low socioeconomic status has been associated with greater to exposure to Helicobacter pylori infection and adverse environmental exposures, both well‐described risk factors for the development of gastric cancer 14 . This is compounded in patients where health literacy is a concern, particularly among racial/ethnic minorities, which may impact all three aspects of the three‐delays model, and subsequently lead to non‐adherence with treatment plans 15 …”

Section: Discussionmentioning

confidence: 99%

Is there a difference in utilization of a perioperative treatment approach for gastric cancer between safety net hospitals and tertiary referral centers?

Turgeon

Lee

Keilson

et al. 2021

Journal of Surgical Oncology

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Background and Objectives Perioperative therapy is a favored treatment strategy for gastric cancer. We sought to assess utilization of this approach at safety net hospitals (SNH) and tertiary referral centers (TRC). Materials and Methods Patients in the US Safety Net Collaborative (2012–2014) with resectable gastric cancer across five SNH and their sister TRC were included. Primary outcomes were receipt of neoadjuvant chemotherapy (NAC) and perioperative therapy. Results Of 284 patients, 36% and 64% received care at SNH and TRC. The distribution of Stage II/III resectable disease was similar across facilities. Receipt of NAC at SNH and TRC was similar (56% vs. 46%, p = 0.27). Compared with overall clinical stage, 38% and 36% were pathologically downstaged at SNH and TRC, respectively. Among patients who received NAC, those who also received adjuvant chemotherapy at SNH and TRC were similar (66% vs. 60%, p = 0.50). Asian race and higher clinical stage were associated with receipt of perioperative therapy (both p < 0.05) while treatment facility type was not. Conclusions There was no difference in utilization of a perioperative treatment strategy between facility types for patients with gastric cancer. Pathologic downstaging from NAC was similar across treatment facilities, suggesting similar quality and duration of therapy. Treatment at an SNH is not a barrier to receiving standard‐of‐care perioperative therapy for gastric cancer.

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Health Literacy in African-American Communities: Barriers and Strategies

Cited by 66 publications

References 43 publications

Disparities in Adherence to COVID-19 Public Health Recommendations

Disparities in Adherence to COVID-19 Public Health Recommendations

Health services utilization, out‐of‐pocket expenditure, and underinsurance among insured non‐elderly cancer survivors in the United States, 2011–2015

Is there a difference in utilization of a perioperative treatment approach for gastric cancer between safety net hospitals and tertiary referral centers?

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