Low Health Literacy and Poor Health Status in Asian Americans and Pacific Islanders in Hawai'i

Abstract

Health literacy is understudied in Asian Americans/Pacific Islanders (AA/PI). We used a population-based sample in Hawai'i to consider if low health literacy is associated with poor health outcomes in Japanese, Filipino, Native Hawaiians, and other AA/PI groups compared with Whites. In data weighted and adjusted for population undercounts and complex survey design, low health literacy varied significantly by group, from 23.9% among Filipinos, 20.6% in Other AA/PI, 16.0% in Japanese, 15.9% in Native Hawaiians, and 13.2% in Whites (χ(2) (4) = 52.22; p < .001). In multivariate models, low health literacy was significantly associated with (a) poor self-reported health in Japanese, Filipinos, Other AA/PI, and Whites; (b) diabetes in Hawaiians and Japanese; and (c) depression for Hawaiians. Low health literacy did not significantly predict overweight/obesity in any ethnic grouping in multivariate models. The design and relevance of health literacy interventions, as well as the pathways that link health literacy to health status, may vary by race/ethnicity, culture, and health outcomes.

After initial treatment for primary breast cancer: information needs, health literacy, and the role of health care workers

“…According to Sørensen et al [13;page 3], health literacy is Blinked to literacy and encompasses people's knowledge, motivation, and competences to access, understand, appraise, and apply health information in order to make judgments and make decisions in everyday life regarding health care, disease prevention, and health promotion to maintain or improve the quality of life during one's life course^. Many empirical studies have shown that a low level of health literacy is linked with poorer health outcomes [14][15][16].…”

The Influence of Community and Individual Health Literacy on Self-Reported Health Status

“…Consistent with prior research, [19][20][21][22] individual health literacy was measured by the self-reported question, "How confident are you filling out medical forms by yourself?" The single self-reported health literacy item has been validated against the most commonly given in-person health literacy tests, performing well in identifying low health literacy (AUROC ≥ 80) against both the Rapid Estimate of Adult Literacy in Medicine and the Test of Functional Health Literacy in Adults.…”

“…Because low health literacy and poor health status have been associated with less education, older age, minority race/ethnicity, rural residence, lack of insurance status, and poverty in previous research, 11,23,24 these characteristics were used as control variables in multivariate models, as was gender, which is associated with both health literacy and health. 1,22,23,24 Race/ethnicity was self-reported from the first racial/ethnic group indicated in response to the question: "What race do you consider yourself to be?" Groups included White, Japanese, Native Hawaiian, Filipino, Chinese, other Asian/Pacific Islander, and other race.…”

“…27 Also, on the individual level, these factors have been associated with both health literacy and self-reported health. 1,22,23,24 Statistical Analyses …”

Brief Health Literacy Screening Items Predict Newest Vital Sign Scores

“…2 Specifically, those with limited HL often lack medical-related knowledge, 3 use fewer preventive services, 4 are more likely to be hospitalized, 5 and experience worse health-related outcomes. 6 Numeracy is a key, but largely understudied, component of HL. This is important for at least 2 reasons.…”