Functional health literacy and diabetes knowledge in a cohort of immigrant Latinos accessing care at an urban community clinic

Purpose: Immigrant Latinos are a highly mobile population known to lack regular sources of healthcare, have limited educational attainment and to face literacy barriers. Therefore, they are less likely to benefit from written health information about diabetes.

Method: We assessed functional health literacy using the Short Test of Functional Health Literacy in Adults (STOFHLA) and diabetes knowledge, calculated as the proportion of knowledge items out of 30 answered correctly using the Diabetes Health Literacy Survey in a cross-sectional sample of 241 immigrant Latino diabetics without formal diabetes education accessing care at an urban community clinic. Descriptive, non-parametric and logistic regression analysis was applied as needed.

Results: STOFHLA scores revealed that 58% had inadequate functional health literacy which did not vary with demographic characteristics. The mean score for diabetes knowledge was 50%+/- 8.7% and varied significantly by income (p<0.05). Diabetes knowledge was positively correlated with STOFHLA score (p<0.05). Eighty-three percent of participants had family history of diabetes, 79% were born in Mexico, 79% reported fair/poor health status, 75% had income <$0,000, and 69% were uninsured.

Conclusion: National and international studies have demonstrated that improving health literacy (an understanding of disease, its consequences and its care) is associated with better health outcomes and improved perceived health status. As the prevalence of diabetes increases particularly for Latinos and other vulnerable populations with limited and/or diminishing literacy skills from chronic disease and aging policy mandating the use of non-written venues and public health campaigns using multi-media to promote diabetes health literacy are needed.