Health Literacy Research and Practice (Apr 2019)

Associations of Acculturation with English- and Spanish-Language Health Literacy Among Bilingual Latino Adults

  • Ashley J. Housten,
  • Diana Stewart Hoover,
  • Virmarie Correa-Fernández,
  • Larkin L. Strong,
  • Whitney L. Heppner,
  • Christine Vinci,
  • David W. Wetter,
  • Claire A. Spears,
  • Yessenia Castro

DOI
https://doi.org/10.3928/24748307-20190219-01
Journal volume & issue
Vol. 3, no. 2
pp. e81 – e89

Abstract

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Background: Low health literacy (HL) is associated with poor health status and outcomes. Racial/ethnic minorities in the United States disproportionately experience low HL and HL-related health disparities. Among Latinos, acculturation is associated with health outcomes, but little is known about the relationship between acculturation and HL. Objective: We examined associations of sociodemographic and acculturation variables with English- and Spanish-language HL among 142 bilingual Latino adults with adequate HL. Methods: HL was assessed in English using the Rapid Estimate of Adult Literacy in Medicine (REALM) and in Spanish with the Short Assessment of Health Literacy for Spanish-speaking Adults (SAHLSA). Acculturation was assessed using the four subscales of the Multidimensional Acculturation Scale-II. Associations of sociodemographic data and acculturation with HL were examined using linear regression. Key Results: Higher education, higher income, higher English proficiency, and lower Latino cultural identification predicted REALM scores (ps <.05) in univariate models. When these variables were entered into a single model, only education and Latino cultural identification were associated with REALM scores. In univariate analyses, the following characteristics were associated with SAHLSA scores: female gender, being partnered, higher education, higher income, being non-US born, lower English proficiency, and higher Spanish proficiency (ps < .05). Education, being non-US born, English proficiency, and Spanish proficiency were each significant in the multivariate model. Conclusions: Results revealed a significant association between acculturation and English- and Spanish-language HL among bilingual Latino adults with adequate HL, suggesting that HL should be assessed in the language in which individuals are most proficient. HL assessed in a nonprimary language may be confounded with language proficiency.

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