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Keene Woods N, Ali U, Medina M, Reyes J, Chesser AK. Health Literacy, Health Outcomes and Equity: A Trend Analysis Based on a Population Survey. J Prim Care Community Health 2023; 14:21501319231156132. [PMID: 36852725 PMCID: PMC10071098 DOI: 10.1177/21501319231156132] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
Health literacy continues to be an issue among minority groups. Population surveys are one strategy used to help better understand health disparities. The Behavioral Risk Factor Surveillance System (BRFSS) in Kansas added health literacy questions to the survey in 2012. This study examined population health literacy levels and health trends from 2012 to 2018. The health status variables included health care coverage status, general health rating, presence of chronic conditions, and length of time since the last check-up. The percentage of individuals reporting low health literacy decreased from 67% in 2012 to 51% in 2018. The percentage of participants with income levels less than $15 000 was 9% in 2012 and 7% in 2018. Health literacy was lowest among the age group 18 to 24-year-olds, those who identified as multiracial, separated, not graduated from high school, out of work for more than 1 year, income less than $10 000, with other living arrangements, and living in a suburban county of metropolitan statistical area. Additionally, many health conditions improved, and those reporting health insurance increased slightly. The study demonstrates how health literacy continues to be an issue, and how education and primary prevention are necessary to improve limited health literacy and health outcomes. Findings from both state-level and national BRFSS population surveys can help educate the public health and clinical health services workforce to provide better care and address health disparities for highrisk populations.
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Affiliation(s)
| | - Umama Ali
- Wichita State University, Wichita, KS, USA
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Svendsen IW, Damgaard MB, Bak CK, Bøggild H, Torp-Pedersen C, Svendsen MT, Berg-Beckhoff G. Employment Status and Health Literacy in Denmark: A Population-Based Study. Int J Public Health 2021; 66:598083. [PMID: 34744563 PMCID: PMC8565272 DOI: 10.3389/ijph.2021.598083] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 02/03/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: Examining whether specific population groups who are not working and those who have an employment have the same health literacy level. Methods: Data were retrieved from a nationally representative cross-sectional study of the Danish population conducted with the health literacy questionnaire (HLS-EU-Q16) in 2016 and 2017. Socio-demographic characteristics were drawn from national registers. Odds ratio for the association between employment status and health literacy was estimated from logistic regression models, adjusted for socio-demographic characteristics. Probability weights were used to adjust for differences in responses. Results: Logistic regression analyses showed that receiving unemployment benefits, social assistance, employment and support allowance, retirement pension and sickness benefit were significantly associated with having inadequate health literacy compared to being employed in any industry. The highest odds ratio for inadequate health literacy was present for receiving unemployment benefit OR = 1.78 (95% CI: 1.23-2.56). Conclusion: Population groups not working and receiving economic public support have higher odds of inadequate health literacy competencies compared to those active in the labor force, considering age and socioeconomic factors. The result contributes to understanding health disparities in connection to occupational situation.
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Affiliation(s)
- Ida W Svendsen
- CIMT - Centre for Innovative Medical Technology, Odense University Hospital, Odense, Denmark.,Unit for Health Promotion Research, Department of Public Health, University of Southern Denmark, Esbjerg, Denmark
| | - Maria B Damgaard
- Unit for Health Promotion Research, Department of Public Health, University of Southern Denmark, Esbjerg, Denmark
| | - Carsten K Bak
- Department of Research and Development, University College South, Esbjerg, Denmark
| | - Henrik Bøggild
- Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.,Unit of Clinical Biostatistics, Aalborg University Hospital, Aalborg, Denmark
| | - Christian Torp-Pedersen
- Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.,Unit of Clinical Biostatistics, Aalborg University Hospital, Aalborg, Denmark
| | - Majbritt T Svendsen
- Department of Cardiology, Centre for Clinical Research, North Denmark Regional Hospital, Hjørring, Denmark
| | - Gabriele Berg-Beckhoff
- Unit for Health Promotion Research, Department of Public Health, University of Southern Denmark, Esbjerg, Denmark.,Hospital South West Jutland, Esbjerg, Denmark
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Jamieson SC, Mallory CW, Jivanji DR, Perez A, Castro G, Barengo NC, Pereira J, Nieder AM. THE ROLE OF HEALTH LITERACY IN PROSTATE CANCER SCREENING. Urology 2021; 163:112-118. [PMID: 34375651 DOI: 10.1016/j.urology.2021.05.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 04/17/2021] [Accepted: 05/02/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To determine if there is an association between self-reported health literacy and rates of prostate cancer screening through PSA testing. METHODS This secondary data analysis utilized information from the 2016 Behavioral Risk Factor Surveillance System (BRFSS). The primary exposure was self-reported health literacy, and the primary outcome was whether patients underwent prior PSA testing. Males 55-69 years old from 13 states were included in the study and were excluded if they had any missing data. Participants were categorized into low, moderate, or high level of health literacy. Confounders were adjusted for using binary logistic regression. Odds ratios (OR) and 95% confidence intervals (CI) were calculated. RESULTS A total of 12,149 participants were included. Five percent of participants reported low health literacy, 54% moderate health literacy, and 41% high health literacy. Compared with study participants who self-reported high levels of health literacy, the odds of undergoing PSA testing were 59% lower in those with low health literacy (OR 0.41; 95% CI 0.28-0.64) and 30% lower in those with moderate health literacy (OR 0.70; 95% CI 0.60-0.83). CONCLUSIONS Our research demonstrates a positive association between self-reported health literacy and the likelihood of PSA screening. While PSA screening can be controversial, health literacy may serve as a window into which patients are more likely to be proactive in their urologic care. Future studies examining how health literacy effects other urologic conditions is necessary.
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Affiliation(s)
- Scott C Jamieson
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA.
| | - Chase W Mallory
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Dhaval R Jivanji
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Alejandra Perez
- Columbia University Division of Urology, Mount Sinai Medical Center, Florida
| | - Grettel Castro
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Noël C Barengo
- Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA; Faculty of Medicine, Riga Stradins University, Riga, Latvia; Department of Public Health, Faculty of Medicine, University of Helsinki, Finland
| | - Jorge Pereira
- Columbia University Division of Urology, Mount Sinai Medical Center, Florida
| | - Alan M Nieder
- Columbia University Division of Urology, Mount Sinai Medical Center, Florida
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Lee SH, Zhang L, Rubin DL, Park S. Associations of Health Literacy and Menu-Labeling Usage With Sugar-Sweetened Beverage Intake Among Adults in Mississippi, 2016. Am J Health Promot 2020; 34:923-928. [PMID: 32436417 PMCID: PMC9006158 DOI: 10.1177/0890117120927302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Examine association of health literacy (HL) and menu-labeling (ML) usage with sugar-sweetened beverage (SSB) intake among adults in Mississippi. DESIGN Quantitative, cross-sectional study. SETTING 2016 Mississippi Behavioral Risk Factor Surveillance System data. PARTICIPANTS Adults living in Mississippi (n = 4549). MEASURES Outcome variable was SSB intake (regular soda, fruit drinks, sweet tea, and sports/energy drinks). Exposure variables were 3 HL questions (find information, understand oral information, and understand written information) and ML usage among adults who eat at fast-food/chain restaurants (user, nonuser, and do not notice ML). ANALYSIS Multinomial logistic regressions were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for SSB intake ≥1 time/d (reference: 0 times/d) associated with HL and ML. RESULTS In Mississippi, 46.8% of adults consumed SSB ≥1 time/d, and 26.9% consumed ≥2 times/d. The odds of consuming SSBs ≥1 time/d were higher among adults with lower HL (aOR = 1.7; 95% CI = 1.3-2.2) than those with higher HL. Among adults who ate at fast-food/chain restaurants, the odds of consuming SSBs ≥1 time/d were higher among nonusers of ML (aOR = 2.3; 95% CI = 1.7-3.1) and adults who did not notice ML (aOR = 1.8; 95% CI = 1.3-2.6) than ML users. CONCLUSION Adults with lower HL and adults who do not use or notice ML consumed more SSBs in Mississippi. Understanding why lower HL and no ML usage are linked to SSB intake could guide the design of interventions to reduce SSB intake in this population.
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Affiliation(s)
- Seung Hee Lee
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA, USA
| | - Lei Zhang
- Office of Health Data & Research, Mississippi State Department of Health, Jackson, MS, USA
| | - Donald L Rubin
- Department of Communication Studies, Franklin College of Arts and Sciences, University of Georgia, Athens, GA, USA
| | - Sohyun Park
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA, USA
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Kerns SL, Fung C, Fossa SD, Dinh PC, Monahan P, Sesso HD, Frisina RD, Feldman DR, Hamilton RJ, Vaughn D, Martin N, Huddart R, Kollmannsberger C, Sahasrabudhe D, Ardeshir-Rouhani-Fard S, Einhorn L, Travis LB. Relationship of Cisplatin-Related Adverse Health Outcomes With Disability and Unemployment Among Testicular Cancer Survivors. JNCI Cancer Spectr 2020; 4:pkaa022. [PMID: 32704617 PMCID: PMC7368467 DOI: 10.1093/jncics/pkaa022] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 03/06/2020] [Indexed: 11/30/2022] Open
Abstract
Background Few data exist on the relationship of cisplatin-related adverse health outcomes (AHOs) with disability, unemployment, and self-reported health (SRH) among testicular cancer survivors (TCS). Methods A total of 1815 TCS at least 1 year postchemotherapy underwent clinical examination and completed questionnaires. Treatment data were abstracted from medical records. A cumulative burden of morbidity score (CBMPt) encompassed the number and severity of platinum-related AHOs (peripheral sensory neuropathy [PSN], hearing loss, tinnitus, renal disease). Multivariable regression assessed the association of AHOs and CBMPt with employment status and SRH, adjusting for sociodemographic and clinical characteristics. Unemployment was compared with a male normative population of similar age, race, and ethnicity. Results Almost 1 in 10 TCS was out of work (2.4%, disability leave; 6.8%, unemployed) at a median age of 37 years (median follow-up = 4 years). PSN (odds ratio [OR] = 2.89, 95% confidence interval [CI] = 1.01 to 8.26, grade 3 vs 0, P = .048), renal dysfunction defined by estimated glomerular filtration rate (OR = 12.1, 95% CI = 2.06 to 70.8, grade 2 vs 0, P = .01), pain (OR = 10.6, 95% CI = 4.40 to 25.40, grade 2 or 3 vs 0, P < .001), and CBMPt (OR = 1.46, 95% CI = 1.03 to 2.08, P = .03) were associated with disability leave; pain strongly correlated with PSN (r2 = 0.40, P < .001). Statistically significantly higher percentages of TCS were unemployed vs population norms (age-adjusted OR = 2.67, 95% CI = 2.49 to 3.02, P < .001). PSN (OR = 2.44, 95% CI = 1.28 to 4.62, grade 3 vs 0, P = .006), patient-reported hearing loss (OR = 1.82, 95% CI = 1.04 to 3.17, grade 2 or 3 vs 0, P = .04), and pain (OR = 3.75, 95% CI = 2.06 to 6.81, grade 2 or 3 vs 0, P < .001) were associated with unemployment. Increasing severity of most cisplatin-related AHOs and pain were associated with statistically significantly worse SRH. Conclusions Our findings have important implications regarding treatment-associated productivity losses and socioeconomic costs in this young population. Survivorship care strategies should include inquiries about disability and unemployment status, with efforts made to assist affected TCS in returning to the workforce.
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Affiliation(s)
- Sarah L Kerns
- University of Rochester Medical Center, Rochester, NY, USA
| | - Chunkit Fung
- University of Rochester Medical Center, Rochester, NY, USA
| | | | | | | | | | | | | | | | - David Vaughn
- University of Pennsylvania, Philadelphia, PA, USA
| | - Neil Martin
- Dana-Farber Cancer Institute, Boston, MA, USA
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Xie Y, Ma M, Zhang Y, Tan X. Factors associated with health literacy in rural areas of Central China: structural equation model. BMC Health Serv Res 2019; 19:300. [PMID: 31077197 PMCID: PMC6509858 DOI: 10.1186/s12913-019-4094-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Accepted: 04/12/2019] [Indexed: 11/23/2022] Open
Abstract
Background Health literacy is a strong predictor of health status. This study develops and tests a structural equation model to explore the factors that are associated with the health literacy level of rural residents in Central China. Methods The participants were recruited from a county-level city in Central China (N = 1164). Face-to-face interviews were conducted to complete the self-designed questionnaire of each participant. The questionnaire included items for the (1) demographic information, (2) socioeconomic status, and (3) health literacy of the participants. Mplus analyses were performed to evaluate the proposed model. Results The final model showed good fit for the data, and both demographic characteristics (i.e., age, BMI, and residence) and socioeconomic status (i.e., monthly income, occupation, and education level) were significantly associated with health literacy level. The effects of these two variables were − 0.277 (P < 0.05) and 0.615 (P < 0.001), respectively, and the model explained 70.2% of the variance in health literacy. Conclusions Health literacy was significantly associated with age, BMI, distance between residence and nearest medical institution, monthly income, occupation, and education level, whereas socioeconomic status was a dominant predictor of health literacy level. Targeting these factors might be helpful in allocating health resources rationally when performing health promotion work. Electronic supplementary material The online version of this article (10.1186/s12913-019-4094-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yaofei Xie
- School of Health Sciences, Wuhan University, No.115 of Donghu Road, Wuhan, 430000, China
| | - Mengdi Ma
- Wuhan Blood Center, No.8 of Baofeng One Road, Wuhan, 430000, China
| | - Ya'nan Zhang
- School of Health Sciences, Wuhan University, No.115 of Donghu Road, Wuhan, 430000, China
| | - Xiaodong Tan
- School of Health Sciences, Wuhan University, No.115 of Donghu Road, Wuhan, 430000, China.
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