Online Program

Can we use preventive care utilization to estimate population health literacy

Monday, November 4, 2013

Larry Warner, MPH, School of Public Health, Brown University, Providence, RI
Background: Health literacy is the ability to obtain, understand, and use basic information to make appropriate health decisions. Currently, there is no validated national health literacy surveillance tool in the literature, which is directly related to health outcomes, and inversely to health care expenditures. National surveys such as the Behavioral Risk Factor Surveillance System lack a direct measure of health literacy, creating the need for a proxy variable. Objective: To assess the ability of the BRFSS to measure trends in adult health literacy. Methods: Preventive care utilization, associated with adequate health literacy, was analyzed using 2009 BRFSS data. Multivariate logistic models were used to regress 1)self-reported health status and 2)a history of one or more chronic conditions against time since last routine checkup as a proxy measure of health literacy, adjusting for race, age, gender, education, income, health coverage and having a primary care provider. Results: Adults without a recent checkup had higher odds of reporting one or more chronic conditions compared to those who had a checkup within the past 12 months (OR 1.26, 95%CI 1.16-1.36). Those without a recent checkup had lower odds of reporting poorer health status compared to those with a recent checkup (OR 0.78, 95%CI 0.72-0.84). Conclusions: Lower estimated health literacy was associated with increased odds of chronic conditions but not self-reported poor health status. Future research should confirm the association of our proxy variable with chronic conditions across multiple years, and future trends validated with concurrent large sample administration of a validated instrument.

Learning Areas:

Administer health education strategies, interventions and programs
Biostatistics, economics
Chronic disease management and prevention
Provision of health care to the public
Public health or related education

Learning Objectives:
Define health literacy. Explain the strengths and limitations of existing health literacy assessment tools. Describe the features of the Behavioral Risk Factor Surveillance System which make it a candidate for health literacy surveillance. Assess the ability of the BRFSS to measure trends in adult health literacy.

Keyword(s): Health Literacy, Health Care Utilization

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Among my research interests has been health literacy as a social determinant of health, and the development of tools for measuring trends in population health literacy.
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.