Health Literacy Needs of Older Chinese Americans

Background: Health literacy plays an important role in health care outcomes. This study assessed health literacy among older Chinese American adults. Methods: In a convenience sample of 312 Chinese American immigrants aged 50 to 75, we used the Single Item Literacy Screener to assess health literacy. We defined respondents as having a ‘health literacy need' when they indicated “sometimes,” “often,” or “always” needing assistance in reading health materials from their doctor or pharmacy. Results: The sample included 23% men, 94% limited English proficient, and 72% not high school graduates. Two-thirds (68%) were found to have a health literacy need. Individuals with limited English proficiency and less than college education were more likely to have this need, 71% and 73%, respectively (p < 0.01). Need was higher among those rating their own health as “poor” or “fair” compared to those rating it “good” or “excellent” (74% vs. 56%, p<0.01). Respondents needing a medical interpreter were more likely than those who did not to have a health literacy need (87% vs. 59%, p<0.001). Respondents with Chinese- versus English-speaking doctors reported similar need (72% vs. 71%, respectively). Conclusions: Older Chinese American adults reported high health literacy need in requiring assistance to read written health information. Lower English fluency, lower educational attainment, and needing a medical interpreter were associated with health literacy need. Having a Chinese-speaking doctor did not alleviate the need. Promoting health literacy should be a focus of efforts to reduce health disparities among older Chinese Americans.