By: Shauna Ayres MPH: Health Behavior candidate 2017
Health disparities have become increasingly apparent in the United States as data collection is becoming cheaper and easier. Attention has been focused on major disease outcomes such as smoking and lung cancer, obesity and diabetes, and inactivity and heart disease. However, there is a key disparity that is often overlooked–health literacy. Health literacy is defined by the National Academy of Medicine as an individual’s capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions (Nielsen-Bohlman, 2004). Health literacy can include knowing where to find healthy recipes, packing sunscreen for a vacation to the beach, researching the side effects of an antidepressant medication, or discussing cancer treatment options with an oncologist. Nearly every decision we make effects some aspect of our health. Therefore, adequate health literacy levels are essential to leading a healthy lifestyle.
Researchers at Michigan State University, North Carolina State University, Health Literacy Services, and Deakin University in Australia examined how various indicators of social inequalities contribute to health literacy disparities. They analyzed data from the 2003 National Assessment of Adult Literacy (NAAL) (N = 14,592) and findings were consistent with previous research describing the association between less favorable social and economic determinants and low health literacy levels. However, they also discovered that civic engagement (e.g. voting, volunteering, and library use) was also independently associated with higher health literacy levels. In addition, ethnic minorities born in the US, English speakers, women, and people who are married all tended to have higher literacy levels (Rikard, 2016).
These results led researchers to conclude that civic participation is a separate indictor for health literacy, apart from social or economic measures. Researchers speculate that people are obtaining health information from social contexts, whether it be from friends, family, neighbors, faith leaders etc. One with more access to other people, can obtain and share more health information and are more health conscious and literate (Oswald, 2016). Researchers are hopeful that future health interventions can target social constructs, including civic engagement, to improve health literacy. Additionally, they encourage the development of new theories and refinement of definitions regarding health literacy (Rikard, 2016).
These results support social network theories and aspects of community-based participatory research (CBPR). It will be interesting to see how civic engagement can be applied to larger public health goals in the future.
Rikard, R. V., Thompson, M. S., McKinney, J., & Beauchamp, A. (2016). Examining health literacy disparities in the united states: A third look at the national assessment of adult literacy (NAAL). BMC Public Health, 16(1), 975. doi:10.1186/s12889-016-3621-9
Nielsen-Bohlman, L., Panzer, A.M., Kindig, D.A. (2004) Health Literacy: A Prescription to End Confusion. The National Academies Press. Washington, D.C.
Oswald, T. (2016, Oct 18). Volunteers and voters have better health literacy. Futurity. http://www.futurity.org/health-literacy-1273502-2/