The Association Between Health Literacy and Healthcare Utilization: Results from the 2015 Georgia Behavioral Risk Factor Surveillance Systems Open Access
Yang, Peter (2017)
Abstract
Background: Only recently has the capacity to study health literacy on a population scale been developed, providing further insight into the dynamics of populations with lower socioeconomic status. Individuals with lower health literacy have been found to have a number of adverse outcomes, especially due to difficulties in utilizing healthcare. In the 2015 Georgia Behavioral Risk Factor Surveillance System (BRFSS), a health literacy module was implemented for the first time in that state. This presented two novel opportunities for study: gauge the distribution of health literacy rates in Georgia and assess their association with efficient healthcare utilization rates varying across chronic disease and health insurance status.
Methods: 4,574 randomly selected Georgia adults, weighted to improve representation of the state population, were contacted via phone survey. Logistic regressions on survey results were conducted using a dichotomized health literacy index score for their association with healthcare utilization behaviors that included having a personal doctor, having had a recent checkup, and consistent doctors' visits. Variables controlled for included socioeconomic demographics, chronic disease status, and health insurance coverage.
Results: The 2015 Georgia BRFSS sample was a representation of the demographics of the state of Georgia after weighting. Descriptive analyses identified health literacy disparities in individuals of lower age, lower educational attainment, lower annual household income, no employment status, disease comorbidity status, and uninsured status. An outcome of health literacy with the outcome variables found significant associations only when not controlling for potential confounders, implying only an overall association of health literacy with healthcare utilizations.
Conclusions: This analysis is the first use of a health literacy instrument that can adequately assess lower health literacy on a state level in Georgia. While the analysis of healthcare utilization found null results, the results combined with descriptive analyses identify potential populations to target for future interventions and study. The current surveillance data and future studies have the potential to inform policy on optimizing the healthcare system by identifying high risk populations to ensure enhanced access for individuals that are less capable of navigating through its complexities.
Table of Contents
Table of Contents
Literature
Review………………………………………….…………………...………1
Health Literacy Definitions, Frameworks,
Measurements………….……………..1
Factors Associated with Health
Literacy…………………………………….……...6
Health Conditions Associated with Health
Literacy………………………....……..6
Health Literacy and Healthcare
Utilization………………………….……………...8
Methods………………………………………………………………………………….10
Data
Source………………………………………………………………….………...11
Data
Measures…………………………………….……………………………..........11
Analysis………………………………………………………………………………..15
Results…………………………………………………………………………………...16
Discussion.........................................................................................................................25
Strengths and
Limitations............................................................................................28
Future
Directions……………………………………………………….…………….30
References………………………………………………………………………….…....31
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