Health literacy, health outcomes and equity: A trend analysis based on a population survey

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Keene Woods, Nikki
Ali, Umama
Medina, Melissa
Reyes, Jared
Chesser, Amy K.

Keene Woods, N., Ali, U., Medina, M., Reyes, J., & Chesser, A. K. (2023). Health Literacy, Health Outcomes and Equity: A Trend Analysis Based on a Population Survey. Journal of Primary Care & Community Health, 14, 21501319231156132.


Health literacy continues to be an issue among minority groups. Population surveys are one strategy used to help better understand health disparities. The Behavioral Risk Factor Surveillance System (BRFSS) in Kansas added health literacy questions to the survey in 2012. This study examined population health literacy levels and health trends from 2012 to 2018. The health status variables included health care coverage status, general health rating, presence of chronic conditions, and length of time since the last check-up. The percentage of individuals reporting low health literacy decreased from 67% in 2012 to 51% in 2018. The percentage of participants with income levels less than 15,000 dollars was 9% in 2012 and 7% in 2018. Health literacy was lowest among the age group 18 to 24-year-olds, those who identified as multiracial, separated, not graduated from high school, out of work for more than 1 year, income less than 10,000 dollars with other living arrangements, and living in a suburban county of metropolitan statistical area. Additionally, many health conditions improved, and those reporting health insurance increased slightly. The study demonstrates how health literacy continues to be an issue, and how education and primary prevention are necessary to improve limited health literacy and health outcomes. Findings from both state-level and national BRFSS population surveys can help educate the public health and clinical health services workforce to provide better care and address health disparities for high risk populations.

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