Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #107214

Shoou-Yih Daniel Lee, PhD, Cecil G. Sheps Center for Health Services Research, University of North Carolina Chapel Hill, 101 Conner Dr. Ste.302, Willowcrest Bldg., CB#3386, Chapel Hill, NC 27599, 919/966-7770, sylee@email.unc.edu, Ahsan M. Arozullah, MD, MPH, General Internal Medicine, University of Illinois at Chicago, 840 South Wood Street, Room 440M, Chicago, IL 60612-7323, Young Ik Cho, MA, PhD, Survey Research Laboratory, University of Illinois at Chicago, 412 South Peoria Street, 6th Floor, Chicago, IL 60607-7069, and Kathleen S. Crittenden, PhD, Sociology, University of Illinois at Chicago, MC 312, 1007 W. Harrison St., Chicago, IL 60607.

About twenty-three percent of American adults have low health literacy, meaning they lack the capability to obtain, process, and understand basic health information and services needed to make appropriate health decisions. According to one estimate, the cost of low health literacy to the U.S. health care system ranges from $30 billion to $73 billion in 1998 U.S. dollars, or about 3.2 to 7.6 percent of personal health care expenditures. In this study, we examine how social support interacts with health literacy in affecting the health status of elderly Medicare enrollees treated at an inter-city medical center in Chicago. Elderly individuals have been found to have the lowest level of health literacy. They also are most likely to have chronic problems and complications from illness that require them to follow an intensive, complex medical regime. Thus, there exists a tremendous mismatch between health need and demand for health literacy among the elderly, subjecting them to a higher risk of adverse medical consequences. A total of 489 English-speaking elderly Medicare enrollees were included in the sample. Individuals with the following conditions were excluded: blindness or severely impaired vision, deafness or impaired hearing, and living in a nursing home or other institution. Health literacy was measured using the Test of Functional Health Literacy in Adults. Social support was assessed with the MOS scale. Health literacy was evaluated based on self-reported general health and SF-12 indicators. A clear pattern emerged in the analysis that Medicare enrollees with both high health literacy (HL) and high social support (SS) had the highest level of health status (self-reported general health, SF-12 physical health, and SF-12 mental health), followed by those with high HL and low SS, low HL and high SS, and low HL and low SS. In multivariate analysis that controlled for gender, ethnicity, age, and educational attainment, “high HL and high SS” showed consistent and positive correlations with the three health status measures. “High HL and low SS” was positively correlated with general health and mental health, whereas “low HL and high SS” was positively correlated with mental health. Overall, results suggest that both health literacy and social support are important determinants for health status in Medicare enrollees and that it is necessary to consider the individual's social conditions while assessing the impact of low health literacy on health status.

Learning Objectives:

(
• To review the findings of health literacy research. (
• To learn about the importance of social support in affecting individual health status. (
• To understand the interaction between health literacy and social support. (
• To discuss intervention strategies that consider both the individual’s literacy ability and social conditions.

Keywords: Health Literacy, Elderly

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.