Health Literacy and Urbanicity Among Cancer Patients. Issue 4 (25th March 2013)

• Record Type: Journal Article
• Authors: Halverson, Julie; Martinez‐Donate, Ana; Trentham‐Dietz, Amy; Walsh, Matthew C.; Strickland, Jeanne Schaaf; Palta, Mari; Smith, Paul D.; Cleary, James
• Is Part Of: Journal of rural health. Volume 29:Issue 4(2013:Autumn)
• Page Start: 392
• Page End: 402
• Publication Date: 2013-03-25
• Subjects: Rural health -- Periodicals; Rural health -- United States -- Periodicals; Medicine, Rural -- Periodicals; Medicine, Rural -- United States -- Periodicals; 362.104257
• DOI: 10.1111/jrh.12018
• Languages: English
• ISSNs: 0890-765X

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="jrh12018-sec-0010" sec-type="section"> <title>Purpose</title> <p>Low health literacy is associated with inadequate health care utilization and poor health outcomes, particularly among elderly persons. There is a dearth of research exploring the relationship between health literacy and place of residence (urbanicity). This study examined the association between urbanicity and health literacy, as well as factors related to low health literacy, among cancer patients.</p> </sec> <sec id="jrh12018-sec-0020" sec-type="section"> <title>Methods</title> <p>A cross‐sectional survey was conducted with a population‐based sample of 1, 841 cancer patients in Wisconsin. Data on sociodemographics, urbanicity, clinical characteristics, insurance status, and health literacy were obtained from the state's cancer registry and participants' answers to a mailed questionnaire. Partially and fully adjusted multivariate logistic regression models were fitted to examine: (1) the association between urbanicity and health literacy and (2) the role of socioeconomic status as a possible mediator of this relationship.</p> </sec> <sec id="jrh12018-sec-0030" sec-type="section"> <title>Findings</title> <p>Rural cancer patients had a 33% (95% CI: 1.06‐1.67) higher odds of having lower levels of health literacy than their counterparts in more urban areas of Wisconsin. The association between urbanicity and health literacy attenuated after controlling for socioeconomic status.</p> </sec> <sec id="jrh12018-sec-0040" sec-type="section"> <title>Conclusions</title> <p>Level of urbanicity was significantly related to health literacy. Socioeconomic status fully mediated the relationship between urbanicity and health literacy. These results call for policies and interventions to assess and address health literacy barriers among cancer patients in rural areas.</p> </sec> </abstract>