267610 Low health literacy, limited English proficiency, and health status in Asians, Latinos, and other racial/ethnic groups in California

Tuesday, October 30, 2012

Tetine Sentell, PhD , Office of Public Health Studies, Univerisity of Hawaii at Manoa, Honolulu, HI
Kathryn Braun, DrPH , University of Hawaii, and Papa Ola Lokahi, Honolulu, HI
Objective. We estimated health status for those with low health literacy and limited-English proficiency alone and in combination for Latino, Chinese, Korean, Vietnamese, and White adults in a population-based sample from California.

Methods. 51,048 adults from the 2007 California Health Interview Survey, including 3,951 with limited-English proficiency, were studied. Multivariate logistic models examined self-reported health by health literacy and English proficiency in both the full sample and racial/ethnic subgroups.

Results. Overall, 44.9% of those with limited-English proficiency reported low health literacy versus 13.8% of English speakers. Among the limited -English proficient, Chinese respondents had the highest prevalence of low health literacy (68.3%), followed by Latinos (45.3%), Koreans (35.6%), Vietnamese (29.6%), and Whites (18.8%). In the full sample, respondents with both limited-English proficiency/low health literacy reported the highest prevalence of poor health (45.1%), followed by limited-English proficiency-only (41.1%), low health literacy-only (22.2%), and neither (13.8%), a hierarchy that remained significant in multivariate models. However, sub-analyses revealed limited-English proficient Latinos, Koreans, and Whites had equal or greater odds of poor health compared with low health literate/limited-English proficient respondents.

Conclusions. Individuals with both limited-English proficiency and low health literacy are at high risk for poor health. Limited-English proficiency may carry greater health risk than low health literacy, though important racial/ethnic variations exist. Public health education and promotion across the lifespan should consider the intersection of health literacy and limited-English proficiency as important factors with individual and combined health consequences.

Learning Areas:
Diversity and culture
Public health or related education

Learning Objectives:
1. Differentiate the health consequences of two major health communication challenges (low health literacy and limited English proficiency) across diverse racial/ethnic groups. 2. Explain the implications of these findings for public health education and promotion across the lifespan.

Keywords: Health Literacy, Vulnerable Populations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conceived and executed this research project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.