Health literacy disparities among Community Health Center Patients in Suffolk County

Background:

Health literacy (individuals' health-related skills and knowledge) is a strong predictor of health outcomes. The present study assessed the health literacy of adult patients attending 8 community health centers in Suffolk County, New York, particularly focusing on identifying disparities in health literacy among patient subgroups.

Methods:

After completing written surveys in waiting rooms, 1061 patients 18 and older were given the verbally-administered Newest Vital Sign (NVS), a validated and quickly administered measure of health literacy designed for clinical settings. 82% of participants completed the English version and 18% the Spanish version.

Results:

75% of participants were female and 60% were U.S.-born. 26% were non-Hispanic white, 31% were non-Hispanic black, and 34% were Hispanic. While 82% of participants had at least a high school diploma or GED, 66% of participants had scores on the NVS indicating limited health literacy. There was a significant difference between the health literacy of white patients (mean score 3.8 ±1.8 on a scale from 0-6) and non-white patients (mean score 2.4 ±1.7). Age, race, education, country of birth, and language of administration were significant predictors of NVS score in the multivariable linear regression model (all p-values <0.0001).

Conclusions:

These findings indicate that educational attainment overestimates actual health literacy skills in this patient population. Public health practitioners serving community health center patients in Suffolk County need to be aware of the prevalence of limited health literacy, particularly among patients from minority racial and ethnic groups, so that they can tailor health education messages and materials accordingly.