MPC Member Publications

This database contains a listing of population studies publications written by MPC Members. Anyone can add a publication by an MPC student, faculty, or staff member to this database; new citations will be reviewed and approved by MPC administrators.

Full Citation

Title: Predicted Health Literacy Disparities Between Immigrant and US-Born Racial/Ethnic Minorities: a Nationwide Study

Citation Type: Journal Article

Publication Year: 2023

ISSN: 15251497

DOI: 10.1007/S11606-023-08082-X/TABLES/4

PMID: 36849863

Abstract: Background: Racial/ethnic minorities in the USA exhibit reduced health literacy (HL) proficiency, leading to increased health disparities. It is unclear how the effect of birth status (immigrant/US-born) affects HL proficiency among racial/ethnic minorities. Objective: To identify the direct, indirect, and total effects of birth status on HL proficiency among a nationally representative population of racial/ethnic minority adults in the USA. Design: A cross-sectional study of 2019 data from the Medial Expenditure Panel Survey. Participants: Participants aged 18 or older reporting as racial/ethnic minorities (Black, Asian, or Hispanic) with non-missing data. Main Measures: We predicted HL proficiency for each participant using a previously published model. Path analysis was used to estimate the direct, indirect, and total effects of birth status on HL proficiency, accounting for several other covariates. Prevalence ratios were estimated using adjusted Poisson regression to evaluate differences in the “Below Basic” HL category. Key Results: An estimated weighted 81,092,505 participants were included (57.5% US-born, 42.5% immigrant). More racial/ethnic minority immigrant participants fell into the lowest category of HL proficiency, “Below Basic” (14.3% vs 5.5%, p < 0.05). Results of the path analysis indicated a significant, negative direct effect of birth status on HL proficiency (standardized coefficient = − 0.24, SE = 0.01, 95%CI: − 0.26, − 0.23) in addition to an indirect effect mediated through insurance status, health-system resource use, and English proficiency. The total effect of birth status on HL proficiency was found to be − 0.29. The immigrant participant group had 81% higher prevalence of falling into the “Below Basic” HL category compared to US-born participants (prevalence ratio = 1.81, 95%CI: 1.52, 2.16). Conclusions: Immigrant status has a strong, negative, direct effect on HL proficiency among racial/ethnic minorities in the USA. This may be a result of barriers that prevent equitable access to resources that improve proper HL proficiency. US policymakers may consider several methods to reduce this disparity at the health-system-, provider-, and patient-levels.

Url: https://link.springer.com/article/10.1007/s11606-023-08082-x

User Submitted?: No

Authors: Sepassi, Aryana; Garcia, Samantha; Tanjasiri, Sora; Lee, Sunmin; Bounthavong, Mark

Periodical (Full): Journal of General Internal Medicine

Issue:

Volume:

Pages: 1-10

Countries:

IPUMS NHGIS NAPP IHIS ATUS Terrapop