COVID-19 Is Connected with Lower Health Literacy in Rural Areas

The relationship between social determinants of health (SDoH) and health outcomes is established and extends to a higher risk of contracting COVID-19. Given the factors included in SDoH, such as education level, race, rurality, and socioeconomic status are interconnected, it is unclear how individual SDoH factors may uniquely impact risk. Lower socioeconomic status often occurs in concert with lower educational attainment, for example. Because literacy provides access to information needed to avoid infection and content can be made more accessible, it is essential to determine to what extent health literacy contributes to successful containment of a pandemic. By incorporating this information into clinical data, we have isolated literacy and geographic location as SDoH factors uniquely related to the risk of COVID-19 infection. For patients with comorbidities linked to higher illness severity, residents of rural areas associated with lower health literacy at the zip code level had a greater likelihood of positive COVID-19 results unrelated to their economic status.

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Disparities in the use of a mHealth medication adherence promotion intervention for low-income adults with type 2 diabetes

Journal of the American Medical Informatics Association ◽

10.1093/jamia/ocv082 ◽

2015 ◽

Vol 23 (1) ◽

pp. 12-18 ◽

Cited By ~ 46

Author(s):

Lyndsay A Nelson ◽

Shelagh A Mulvaney ◽

Tebeb Gebretsadik ◽

Yun-Xian Ho ◽

Kevin B Johnson ◽

...

Keyword(s):

Type 2 Diabetes ◽

Depressive Symptoms ◽

Medication Adherence ◽

Health Literacy ◽

Low Income ◽

Mhealth Intervention ◽

Lower Health ◽

The Relationship ◽

Lower Health Literacy

Abstract Objective Mobile health (mHealth) interventions may improve diabetes outcomes, but require engagement. Little is known about what factors impede engagement, so the authors examined the relationship between patient factors and engagement in an mHealth medication adherence promotion intervention for low-income adults with type 2 diabetes (T2DM). Materials and Methods Eighty patients with T2DM participated in a 3-month mHealth intervention called MEssaging for Diabetes that leveraged a mobile communications platform. Participants received daily text messages addressing and assessing medication adherence, and weekly interactive automated calls with adherence feedback and questions for problem solving. Longitudinal repeated measures analyses assessed the relationship between participants’ baseline characteristics and the probability of engaging with texts and calls. Results On average, participants responded to 84.0% of texts and participated in 57.1% of calls. Compared to Whites, non-Whites had a 63% decreased relative odds (adjusted odds ratio [AOR] = 0.37, 95% confidence interval [CI], 0.19-0.73) of participating in calls. In addition, lower health literacy was associated with a decreased odds of participating in calls (AOR = 0.67, 95% CI, 0.46-0.99, P = .04), whereas older age ( Pnonlinear = .01) and more depressive symptoms (AOR = 0.62, 95% CI, 0.38-1.02, P = .059) trended toward a decreased odds of responding to texts. Conclusions Racial/ethnic minorities, older adults, and persons with lower health literacy or more depressive symptoms appeared to be the least engaged in a mHealth intervention. To facilitate equitable intervention impact, future research should identify and address factors interfering with mHealth engagement.

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Lower health literacy predicts smoking relapse among racially/ethnically diverse smokers with low socioeconomic status

BMC Public Health ◽

10.1186/1471-2458-14-716 ◽

2014 ◽

Vol 14 (1) ◽

Cited By ~ 22

Author(s):

Diana W Stewart ◽

Miguel Ángel Cano ◽

Virmarie Correa-Fernández ◽

Claire Adams Spears ◽

Yisheng Li ◽

...

Keyword(s):

Socioeconomic Status ◽

Health Literacy ◽

Low Socioeconomic Status ◽

Ethnically Diverse ◽

Smoking Relapse ◽

Low Socioeconomic ◽

Lower Health ◽

Lower Health Literacy

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Drug Use and Life Chaos as Potential Factors Contributing to HIV Viral Load among People with Lower Health Literacy

Substance Use & Misuse ◽

10.1080/10826084.2021.1884722 ◽

2021 ◽

Vol 56 (5) ◽

pp. 606-614

Author(s):

Seth C. Kalichman ◽

Moira O. Kalichman ◽

Ellen Banas ◽

Marnie Hill ◽

Harold Katner

Keyword(s):

Viral Load ◽

Health Literacy ◽

Drug Use ◽

Hiv Viral Load ◽

Lower Health ◽

Potential Factors ◽

Lower Health Literacy

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Association between socio-economic status and sexual behavior of adolescents

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh0706321v ◽

2007 ◽

Vol 135 (5-6) ◽

pp. 321-325 ◽

Cited By ~ 6

Author(s):

Dejana Vukovic ◽

Vesna Bjegovic-Mikanovic

Keyword(s):

Socioeconomic Status ◽

Sexual Behavior ◽

Sexual Behaviors ◽

Risky Sexual Behavior ◽

Economic Status ◽

First Grade ◽

Sexually Active ◽

Lower Socioeconomic Status ◽

Lower Socioeconomic ◽

Self Administered Questionnaire

Introduction: Numerous studies have emphasized the importance of contextual factors as determinants of sexual behavior of adolescents. It has been found that lower socioeconomic status is associated with risky sexual behavior. Sexual behavior is individual but develops under strong influence of cultural and other influences. Objective. The aim of this study was to investigate the association of family?s socioeconomic status and risky sexual behavior of adolescents in Belgrade. Method. Self-administered questionnaire was used in secondary schools in Belgrade, and 1,782 adolescents attending first grade filled the questionnaire. For the analyses of predictors of risky sexual behavior, multiple logistic regression was used. Results. Parents? occupations did not show significant association with any of analyzed behaviors. Adolescents who received weekly disposable money above average were 2.5 times more likely to ever have had sexual intercourse, and if sexually active were more likely to use contraception. Perceived family?s wealth was a significant predictor of ever having sex (OR=1.9; CI 1.2-2.8) and not using contraception (OR=4.3; CI 1.2-15.0). Conclusion. Socioeconomic status is associated with sexual behaviors of adolescents. Fifteen-year olds who perceive their families as wealthier are more likely to ever have had sex and not use any kind of contraception. Adolescents with higher weekly income are more likely to ever have had sex and use contraception than their counterpats with less weekly disposable money. .

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Impact of Socioeconomic Status and Race on Sepsis Epidemiology and Outcomes

The Journal of Applied Laboratory Medicine ◽

10.1093/jalm/jfaa151 ◽

2020 ◽

Author(s):

Emi Minejima ◽

Annie Wong-Beringer

Keyword(s):

Socioeconomic Status ◽

Low Income ◽

Formal Education ◽

Geographic Location ◽

The United States ◽

Risk Scores ◽

Low Ses ◽

The Relationship ◽

Poor Health Literacy ◽

Hispanic White

Abstract Background Socioeconomic status (SES) is a complex variable that is derived primarily from an individual’s education, income, and occupation and has been found to be inversely related to outcomes of health conditions. Sepsis is the sixth most common admitting diagnosis and one of the most costly conditions for in-hospital spending in the United States. The objective of this review is to report on the relationship between SES and sepsis incidence and associated outcomes. Content Sepsis epidemiology varies when explored by race, education, geographic location, income, and insurance status. Sepsis incidence was significantly increased in individuals of Black race compared with non-Hispanic white race; in persons who have less formal education, who lack insurance, and who have low income; and in certain US regions. People with low SES are likely to have onset of sepsis significantly earlier in life and to have poorly controlled comorbidities compared with those with higher SES. Sepsis mortality and hospital readmission is increased in individuals who lack insurance, who reside in low-income or medically underserved areas, who live far from healthcare, and who lack higher level education; however, a person’s race was not consistently found to increase mortality. Summary Interventions to minimize healthcare disparity for individuals with low SES should target sepsis prevention with increasing measures for preventive care for chronic conditions. Significant barriers described for access to care by people with low SES include cost, transportation, poor health literacy, and lack of a social network. Future studies should include polysocial risk scores that are consistently defined to allow for meaningful comparison across studies.

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Does health literacy mediate the relationship between socioeconomic status and health disparities? Integrative review

Health Promotion International ◽

10.1093/heapro/day062 ◽

2018 ◽

Vol 34 (5) ◽

pp. e1-e17 ◽

Cited By ~ 35

Author(s):

Coraline Stormacq ◽

Stephan Van den Broucke ◽

Jacqueline Wosinski

Keyword(s):

Socioeconomic Status ◽

Risk Factor ◽

Health Disparities ◽

Health Literacy ◽

Comparison Method ◽

Socioeconomic Disparities ◽

Modifiable Risk Factor ◽

Mediating Role ◽

The Relationship

Summary While socioeconomic disparities are among the most fundamental causes of health disparities, socioeconomic status (SES) does not impact health directly. One of the potential mediating factors that link SES and health is health literacy (HL). Yet although HL can be considered a modifiable risk factor of socioeconomic disparities in health, the relationship between SES, HL and health disparities is not well understood. This study reviewed the evidence regarding the mediating role of HL in the relationship between socioeconomic and health disparities. Medline, Cinahl, Embase, PsychInfo, Eric, Web of Science, Google, Google Scholar, Mednar, Doaj and Worldcat were used to retrieve studies that specifically addressed socioeconomic and socio-demographic factors related to low HL levels, as well as the mediating role of HL in the relationship between SES and disparities in health outcomes. Selected studies were assessed for methodological quality. Sixteen published studies were retained for inclusion and content analyzed using the constant comparison method. The review indicates that disadvantaged social and socioeconomic conditions contribute to low HL levels, whereby low SES, and particularly educational attainment, is the most important determinant of HL, and that HL mediates the relationship between SES and health status, quality of life, specific health-related outcomes, health behaviors and use of preventive services. HL can be considered as a modifiable risk factor of socioeconomic disparities in health. Enhancing the level of HL in the population or making health services more accessible to people with low HL may be a means to reach a greater equity in health.

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Association of Health Literacy and Socioeconomic Status with Oral Health Among Older Adults in Ghana: A Moderation Analysis of Social Capital

Journal of Applied Gerontology ◽

10.1177/07334648211028391 ◽

2021 ◽

pp. 073346482110283

Author(s):

Padmore Adusei Amoah ◽

Adwoa Owusuaa Koduah ◽

Razak M. Gyasi ◽

Kingsley Atta Nyamekye ◽

David R. Phillips

Keyword(s):

Social Capital ◽

Socioeconomic Status ◽

Health Status ◽

Oral Health ◽

Health Literacy ◽

Oral Health Status ◽

Cross Sectional Survey ◽

Cross Sectional ◽

The Relationship

We examined the moderating role of social capital (SC) in the association of socioeconomic status (SES) and health literacy (HL) with oral health (OH) status and the intentions to use OH services (IUOHS) among older Ghanaians. Data were derived from a cross-sectional survey ( n = 522) and analyzed using ordinal and binary logistic regressions. Bridging SC moderated the relationship between HL and oral health status ( B = 0. 0.117, p < .05) and the association of SES with IUOHS (adjusted odds ratio [AOR] = 1.144; 95% confidence interval [CI] = [1.027, 3.599]). Trust modified the association between HL and IUOHS (AOR = 1.051; 95% CI = [1.014, 3.789]). Bonding SC moderated the association between SES and oral health status (B = 0.180, p < .05). However, bonding SC negatively modified the association between SES and IUOHS (AOR = 0.961; 95% CI = [0.727, 0.997]). Cognitive and structural SC modify the associations of SES and HL with OH and IUOHS.

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Relationship between nutrition knowledge and dietary intake

British Journal Of Nutrition ◽

10.1017/s0007114514000087 ◽

2014 ◽

Vol 111 (10) ◽

pp. 1713-1726 ◽

Cited By ~ 188

Author(s):

Inge Spronk ◽

Charina Kullen ◽

Catriona Burdon ◽

Helen O'Connor

Keyword(s):

Health Literacy ◽

Dietary Intake ◽

Nutrition Education ◽

Economic Status ◽

Meta Analysis ◽

Nutrition Knowledge ◽

Dietary Guidelines ◽

Original Research ◽

High Quality Research ◽

The Relationship

The present systematic review examined the relationship between nutrition knowledge and dietary intake in adults (mean age ≥ 18 years). Relevant databases were searched from the earliest record until November 2012. Search terms included: nutrition; diet or food knowledge and energy intake; feeding behaviour; diet; eating; nutrient or food intake or consumption. Included studies were original research articles that used instruments providing quantitative assessment of both nutrition knowledge and dietary intake and their statistical association. The initial search netted 1 193 393 potentially relevant articles, of which twenty-nine were eligible for inclusion. Most of them were conducted in community populations (n22) with fewer (n7) in athletic populations. Due to the heterogeneity of methods used to assess nutrition knowledge and dietary intake, a meta-analysis was not possible. The majority of the studies (65·5 %: community 63·6 %; athletic 71·4 %) reported significant, positive, but weak (r< 0·5) associations between higher nutrition knowledge and dietary intake, most often a higher intake of fruit and vegetables. However, study quality ranged widely and participant representation from lower socio-economic status was limited, with most participants being tertiary educated and female. Well-designed studies using validated methodologies are needed to clarify the relationship between nutrition knowledge and dietary intake. Diet quality scores or indices that aim to evaluate compliance to dietary guidelines may be particularly valuable for assessing the relationship between nutrition knowledge and dietary intake. Nutrition knowledge is an integral component of health literacy and as low health literacy is associated with poor health outcomes, contemporary, high-quality research is needed to inform community nutrition education and public health policy.

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HUBUNGAN STATUS SOSIAL EKONOMI ORANGTUA DENGAN MOTIVASI BELAJAR PADA MAHASISWA ANGKATAN 2013 FAKULTAS KEDOKTERAN UNIVERSITAS SAM RATULANGI

Jurnal e-Biomedik ◽

10.35790/ebm.3.1.2015.7125 ◽

2015 ◽

Vol 3 (1) ◽

Author(s):

Caroline R.M. Karouw ◽

Henry Opod ◽

Jehosua S.V. Sinolungan

Keyword(s):

Socioeconomic Status ◽

Learning Process ◽

Human Life ◽

Economic Status ◽

Learning Motivation ◽

Motivation To Learn ◽

Socio Economic Status ◽

Abstract Learning ◽

Relationship Of ◽

The Relationship

Abstract: Learning is a process that can not be separated from human life. Psychic impulse to learn is the motivation to learn. In the learning process, parents are among the factors that have a role. This study aims to determine the relationship of socio-economic status of parents with students' learning motivation. Data were collected through questionnaires. The results showed there was no correlation between socio-economic status of parents with learning motivation of Medicine Faculty Sam Ratulangi University class of 2013 students p = 0.444 (p > 0.05) and the correlation value is -0.062. It can be concluded that there was no correlation between socioeconomic status of parents with students’ learning motivation.Keywords: socio-economic status, learning motivationAbstrak : Belajar merupakan proses yang tidak dapat dipisahkan dari kehidupan manusia,, Dorongan psikis dalam diri untuk belajar merupakan motivasi belajar. Dalam proses belajar, orangtua merupakan salah satu faktor yang memiliki peran. Penelitian ini bertujuan untuk mengetahui hubungan status sosial ekonomi orangtua dengan motivasi belajar mahasiswa. Pengambilan data melalui kuesioner. Hasil penelitian menunjukkan tidak ada hubungan antara status sosial ekonomi orangtua dengan motivasi belajar mahasiswa angkatan 2013 Fakultas Kedokteran Universitas Sam Ratulangi p=0,444 (p > 0,05) dan nilai korelasi sebesar -0,062. Dapat disimpulkan bahwa tidak terdapat hubungan antara status sosial ekonomi orangtua dengan motivasi belajar mahasiswa.Kata kunci: Status sosial ekonomi, motivasi belajar

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Citizen Responses to Government Restrictions in Switzerland During the COVID-19 Pandemic: Cross-Sectional Survey

JMIR Formative Research ◽

10.2196/20871 ◽

2020 ◽

Vol 4 (12) ◽

pp. e20871 ◽

Cited By ~ 1

Author(s):

Kevin Selby ◽

Marie-Anne Durand ◽

Alexandre Gouveia ◽

Francesca Bosisio ◽

Gaia Barazzetti ◽

...

Keyword(s):

Health Literacy ◽

Sex Education ◽

Mitigation Measures ◽

Free Text ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Literacy Knowledge ◽

Lower Health ◽

The Government ◽

Lower Health Literacy

Background The success of government-recommended mitigation measures during the COVID-19 pandemic depends largely on information uptake and implementation by individual citizens. Objective Our aim was to assess citizens’ knowledge and perceptions about COVID-19 recommendations in the Canton of Vaud, Switzerland. Methods A cross-sectional electronic survey with open and closed questions was disseminated by community-based partners prior to the relaxation of government restrictions. Outcomes included citizen knowledge (9-question measure) and worry about the virus, perception of government measures, and recommendations for improvements. Comparisons used linear regression, controlling for age, sex, education, and health literacy. Free-text answers were analyzed thematically. Results Of 807 people who accessed the survey, 684 (85%) completed all questions and 479 (60%) gave free-text recommendations. Overall, 75% were female, the mean age was 48 years, and 93% had high health literacy. Knowledge scores were high, with a median score of 8 out of 9. Mean levels of worry about the COVID-19 pandemic were higher in women than men (55/100 versus 44/100, P<.001), and in respondents with lower health literacy (57/100 versus 52/100, P=.03). Self-reported adherence to recommendations was high (85%) and increased with age and worry (both P<.001). Respondents rated their own adherence higher than others (85% versus 61%, P<.001). Moreover, 34% of respondents reported having self-quarantined; this rose to 52% for those aged ≥75 years. Those who had self-quarantined reported higher levels of fear. Nearly half (49%) of respondents felt the government response had been adequate, though younger age and higher levels of worry were associated with considering the response to be insufficient (both P<.001). Analysis of open-text answers revealed 4 major themes: access to and use of masks, gloves, and hand sanitizer; government messaging; lockdown and lockdown exit plan communication; and testing for COVID-19. Conclusions Knowledge, adherence, and satisfaction regarding government recommendations and response were high in this sample, but many desired greater access to personal protective equipment. Those with lower health literacy and those who have been in self-isolation reported greater concerns about the pandemic.

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