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American Public Health Association
133rd Annual Meeting & Exposition
December 10-14, 2005
Philadelphia, PA
APHA 2005
 
4055.0: Tuesday, December 13, 2005 - 8:30 AM

Abstract #109943

Examining the Mechanisms of How Health Literacy Relates to Health Status and Health Service Utilization among Medicare Enrollees

Young Ik Cho, MA, PhD, Survey Research Laboratory, University of Illinois at Chicago, 412 South Peoria Street, 6th Floor, Chicago, IL 60607-7069, (312) 996-5271, youngcho@uic.edu, 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, Ahsan M. Arozullah, MD, MPH, General Internal Medicine, University of Illinois at Chicago, 840 South Wood Street, Room 440M, Chicago, IL 60612-7323, and Kathleen S. Crittenden, PhD, Sociology, University of Illinois at Chicago, MC 312, 1007 W. Harrison St., Chicago, IL 60607.

Research has related low health literacy to many adverse health consequences. Although empirical evidence is scarce, a consensus has been reached that low health literacy may affect health status and hospitalization indirectly, through a set of intermediate factors that pertain to patients' disease knowledge and health seeking behavior. One factor is poor disease knowledge, which has been shown in many studies to have a consistent relationship with low health literacy. There are other factors -- e.g., worse health behavior, less regular preventive care and physician visits, and lower compliance. However, these factors either display an inconsistent relationship with health literacy or have not been empirically examined in studies to date. With data collected from face-to-face interviews with 489 Medicare outpatients and their hospital admission records, we tested a path model to examine the indirect effects of health literacy on health status and health service utilization through five intermediate conditions: (1) knowledge of diseases and self-care; (2) health behavior; (3) preventive care; and (4) medical compliance. We found that individuals with lower health literacy are likely to have poorer medical knowledge and worse health behavior. Poor knowledge, worse health behavior and lack of compliance in turn, are related to poor mental health outcomes. Also, positive health behavior and preventive care concurrently decrease the use of hospital services.

Learning Objectives:

Keywords: Health Literacy, Health Behavior

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.

[ Recorded presentation ] Recorded presentation

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The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA