1
|
Dela Cruz R, Galbreath J, Butel J, Yamanaka AB, Wilkens LR, Aflague T, Coleman P, Shallcross L, McFall P, Novotny R. Social determinants of health literacy among parents and caregivers in the US-Affiliated Pacific. Health Promot Int 2024; 39:daae002. [PMID: 38294036 PMCID: PMC10828926 DOI: 10.1093/heapro/daae002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024] Open
Abstract
Health literacy is understudied in the US-Affiliated Pacific (USAP), where local populations have historically experienced social marginalization and disproportionate health inequities caused by the social determinants of health (SDOH). This cross-sectional study analyzed several SDOH indicators-acculturation, use of food assistance programs and demographic characteristics (race and ethnicity, household income, primary language spoken at home and educational attainment)-and their relationship to health literacy among 1305 parents/caregivers of young children ages 2-8 years old who participated in the Children's Healthy Living (CHL) program in Alaska, American Samoa, Commonwealth of the Northern Mariana Islands (CNMI), Guam, and Hawai'i. Significantly increased odds of low health literacy were found among parents/caregivers with households where a language other than English was the primary language compared to English-only households (OR = 1.86, 95% CI = 1.22, 2.82), household income of <$35 000 compared to ≥$35 000 (OR = 2.15, 95% CI = 1.13, 4.07), parents/caregivers of Asian children compared to parents/caregivers of White children (OR = 2.68, 95% CI = 1.05, 6.84), parent/caregivers with less than or some high school education compared to high school completion (1st- to 8th-grade OR = 4.46, 95% CI = 2.09, 9.52; 9th- to 11th-grade OR 1.87, 95% CI = 1.06, 3.30) and parent/caregivers with acculturation status defined as marginalized as compared to integrated (OR = 2.31, 95% CI = 1.09, 4.86). This study indicates that some USAP parents/caregivers may lack the capacity to acquire health information, utilize health resources, and navigate health decision making. Future efforts to understand and improve health literacy in the USAP should be population specific, thoroughly assess personal and organizational health literacy, and inventory community health care capacity.
Collapse
Affiliation(s)
- Rica Dela Cruz
- Human Nutrition, Food and Animal Sciences Department, College of Tropical Agriculture and Human Resources, University of Hawai‘i at Mānoa, 1955 East-West Rd, Honolulu, HI 96822, USA
| | - Jennifer Galbreath
- Human Nutrition, Food and Animal Sciences Department, College of Tropical Agriculture and Human Resources, University of Hawai‘i at Mānoa, 1955 East-West Rd, Honolulu, HI 96822, USA
| | - Jean Butel
- Human Nutrition, Food and Animal Sciences Department, College of Tropical Agriculture and Human Resources, University of Hawai‘i at Mānoa, 1955 East-West Rd, Honolulu, HI 96822, USA
| | - Ashley B Yamanaka
- Human Nutrition, Food and Animal Sciences Department, College of Tropical Agriculture and Human Resources, University of Hawai‘i at Mānoa, 1955 East-West Rd, Honolulu, HI 96822, USA
| | - Lynne R Wilkens
- Population Sciences in the Pacific Program, University of Hawai‘i Cancer Center, 701 Ilalo St, Honolulu, HI 96813, USA
| | - Tanisha Aflague
- College of Natural and Applied Sciences, University of Guam, 303 University Drive, UOG Station, Mangilao, GU 96923, USA
| | - Patricia Coleman
- Cooperative Research, Extension and Education Services, Northern Marianas College, PO Box 501250, Saipan, MP 96950, USA
| | - Leslie Shallcross
- Cooperative Extension Service, University of Alaska Fairbanks, 1000 University Avenue, Fairbanks, AK 99709, USA
| | - Pauline McFall
- Human Nutrition, Food and Animal Sciences Department, College of Tropical Agriculture and Human Resources, University of Hawai‘i at Mānoa, 1955 East-West Rd, Honolulu, HI 96822, USA
- Agriculture, Community, and Natural Resources, American Samoa Community College, PO Box 2609, Pago Pago, AS 96799, USA
| | - Rachel Novotny
- Human Nutrition, Food and Animal Sciences Department, College of Tropical Agriculture and Human Resources, University of Hawai‘i at Mānoa, 1955 East-West Rd, Honolulu, HI 96822, USA
| |
Collapse
|