Edward Jean, Morris Sarah, Mataoui Fatma, Granberry Phillip, Williams Mark V, Torres Idali
Center for Health Services Research, University of Kentucky, Lexington, KY, USA.
Datalys Center for Sports Injury Research and Prevention, Inc., Indianapolis, IN, USA.
Public Health Nurs. 2018 May;35(3):176-183. doi: 10.1111/phn.12385. Epub 2018 Jan 26.
The aim of this study was to assess the impact of health literacy (HL) and health insurance literacy (HIL) on health insurance status and access to health care services for Spanish-speaking communities living in Massachusetts.
A total of 139 surveys (descriptive, knowledge-based HIL questions, and Short Assessment of Health Literacy in Spanish) and 30 semi-structured interviews were collected and analyzed using chi-square, Mann-Whitney U test, and logistic regression analysis.
The majority of participants had inadequate HL (56%) and HIL (93%). There were differences in HL scores (t = 4.1; p < .0001) between the insured (M = 12.3, SD = 5.7) and uninsured (M = 7.9, SD = 6.7) and differences (t = 1.9; p = .05) between those with adequate HIL (M = 14.3, SD = 4.3) and inadequate HIL (M = 10.2, SD = 6.6). Participants who were uninsured (MW U = 37.6; p < .0001) and who had inadequate HL (MW U = 5.2; p = .02) were more likely to have never accessed health care in the U.S. Participants who had never accessed health care were 93% less likely to be insured and those with adequate HL were three times more likely to be insured.
Health literacy and HIL are closely associated with insurance status and access to health care for Spanish-speaking communities, indicating the need for further research and enhanced public health efforts to improve knowledge and awareness around navigating health care systems.
本研究旨在评估健康素养(HL)和健康保险素养(HIL)对居住在马萨诸塞州的讲西班牙语社区的健康保险状况及获得医疗服务的影响。
共收集了139份调查问卷(描述性、基于知识的HIL问题以及西班牙语健康素养简短评估)和30份半结构化访谈,并使用卡方检验、曼-惠特尼U检验和逻辑回归分析进行分析。
大多数参与者的HL(56%)和HIL(93%)不足。参保者(M = 12.3,标准差 = 5.7)和未参保者(M = 7.9,标准差 = 6.7)的HL得分存在差异(t = 4.1;p <.0001),HIL充足者(M = 14.3,标准差 = 4.3)和HIL不足者(M = 10.2,标准差 = 6.6)之间也存在差异(t = 1.9;p =.05)。未参保者(MW U = 37.6;p <.0001)和HL不足者(MW U = 5.2;p =.02)更有可能从未在美国获得过医疗服务。从未获得过医疗服务的参与者参保的可能性降低93%,而HL充足者参保的可能性是其三倍。
健康素养和HIL与讲西班牙语社区的保险状况及获得医疗服务密切相关,这表明需要进一步研究并加强公共卫生工作,以提高围绕医疗保健系统导航的知识和意识。