O'Leary Catina, Eder Milton Mickey, Goli Sumana, Pettyjohn Sam, Rattine-Flaherty Elizabeth, Jatt Yousra, Cottler Linda B
Health Literacy Media, St Louis, MO 63112, United States.
Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN 55455, United States.
J Am Med Inform Assoc. 2025 Jun 1;32(6):1025-1031. doi: 10.1093/jamia/ocae225.
The objective was to understand the association between people with adequate and inadequate health literacy (HL) in the All of Us cohort.
Overall, health survey responses to 3 questions from 246 555 people, ages 18-77 years in the controlled tier V7 dataset, were used to assess and compare HL. HL scores ranged from 3 to 15, with scores ≤9 indicating inadequate HL and >9 indicating adequate HL.
Cohort participants' responses indicate 92.4% met criteria for adequate HL. Persons with inadequate HL versus adequate HL were likely to be Gen X, male, Black, report an income less than $25k, and have less than a high school education. Furthermore, the rate of HL may not represent that for the broader US population.
All of Us participants had much higher rates of HL than that for the 2003 National Assessment of Adult Literacy, suggesting approximately over 90% of the US population has HL challenges. The All of Us cohort's high rates of HL may reflect response and recruitment bias. Given the emphasis on diversity and inclusion within the cohort, and understanding HL as the ability to find, understand, and use health information, revisiting the recruitment strategies and, potentially, the assessment of HL within the All of Us cohort is recommended.
Factoring HL into diversity and inclusion research recruitment efforts will require review and testing of innovative approaches to community recruitment, engagement, and retention methods. Infusing HL into precision medicine can advance opportunities for individual improvement in health promotion and disease management. Future population level efforts in precision medicine should consider more sensitive measures to critical social determinants of health, such as health literacy, to more carefully characterize diversity and inclusion in these studies.
本研究旨在了解“我们所有人”队列中健康素养（HL）充足和不足的人群之间的关联。
总体而言，在受控的V7数据集中，对246555名年龄在18 - 77岁的人群的健康调查中3个问题的回答被用于评估和比较健康素养。健康素养得分范围为3至15分，得分≤9分表明健康素养不足，得分>9分表明健康素养充足。
队列参与者的回答表明，92.4%的人符合健康素养充足的标准。健康素养不足的人群与健康素养充足的人群相比，更可能是X世代、男性、黑人，报告收入低于25000美元，且受教育程度低于高中。此外，健康素养率可能无法代表更广泛的美国人群的情况。
“我们所有人”项目的参与者的健康素养率远高于2003年全国成人识字能力评估的结果，这表明约90%以上的美国人群存在健康素养方面的挑战。“我们所有人”队列的高健康素养率可能反映了应答和招募偏差。鉴于该队列强调多样性和包容性，并将健康素养理解为查找、理解和使用健康信息的能力，建议重新审视招募策略，并可能重新评估“我们所有人”队列中的健康素养。
将健康素养纳入多样性和包容性研究招募工作中，需要对社区招募、参与和留存方法的创新途径进行审查和测试。将健康素养融入精准医学可以为个人在健康促进和疾病管理方面的改善创造更多机会。未来精准医学在人群层面的努力应考虑对健康的关键社会决定因素采取更敏感的措施，如健康素养，以便在这些研究中更仔细地描述多样性和包容性。
