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THE RELATIONSHIP BETWEEN A SYNTHETIC ESTIMATE OF FUNCTIONAL HEALTH LITERACY AND PREVENTIVE HEALTH CARE USE IN A NATIONAL SAMPLE OF ELDERLY

Miller, Michael Joseph (2004) THE RELATIONSHIP BETWEEN A SYNTHETIC ESTIMATE OF FUNCTIONAL HEALTH LITERACY AND PREVENTIVE HEALTH CARE USE IN A NATIONAL SAMPLE OF ELDERLY. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Abstract

Functional health literacy is one path through which the educational system, health system, culture and society intersect to influence health outcomes and their associated costs. Inadequate functional health literacy can impair oral and written communication and subsequently the ability to understand the prevention and self-management of disease. Despite these concerns, the national prevalence of inadequate, marginal and adequate functional health literacy and their association with health status, health care utilization and subsequent health care outcomes remain largely unknown. For those tasked with the responsibility of managing population health, there is a void of tools and techniques that can be used to efficiently identify those at greatest risk of inadequate functional health literacy. Using standard regression modeling and diagnostic techniques, this study was the first to develop and validate a model to estimate functional health literacy and to confirm its direct relationship with preventive health services utilization in a nationally representative sample of elderly >= 65 years of age. The national prevalence of inadequate and marginal functional health literacy was estimated to be 39%. Preventive health care utilization varied by functional health literacy category. Individuals with inadequate or marginal functional health literacy had odds of not receiving a flu shot within the past 12 months that was 1.26 times that of individuals with adequate functional health literacy (OR = 1.26, 95% CI (1.11 - 1.43)) after controlling for income, insurance coverage, having a usual source of care, and self-reported general health status. Women with inadequate or marginal functional health literacy had odds of not ever having a mammogram that was 2.21 times that of women with adequate functional health literacy (OR = 2.21, 95% CI (1.85 - 2.65)) in multivariate analysis. This research confirms the national public health relevance of functional health literacy in preventive health care utilization in the elderly. Race, education and age-related disparities in preventive health care utilization may, in part, be mediated through functional health literacy. As we move to equalize health care access, utilization and quality for all, functional health literacy must be considered part of the solution if we are to empower those in greatest need.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Miller, Michael Josephmichael.miller@drake.edu
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairDegenholtz, Howard Bdegen@pitt.eduDEGEN
Committee MemberLin, Chyongchiou Jengcjlin@pitt.eduCJLIN
Committee MemberRicci, Edmund Memricci@pitt.eduEMRICCI
Committee MemberSereika, Susan Mssereika@pitt.eduSSEREIKA
Date: 3 December 2004
Date Type: Completion
Defense Date: 9 August 2004
Approval Date: 3 December 2004
Submission Date: 2 December 2004
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Behavioral and Community Health Sciences
Degree: DrPH - Doctor of Public Health
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: flu shot; health literacy; mammogram; elderly; preventive health care
Other ID: http://etd.library.pitt.edu/ETD/available/etd-12022004-001521/, etd-12022004-001521
Date Deposited: 10 Nov 2011 20:07
Last Modified: 15 Nov 2016 13:52
URI: http://d-scholarship.pitt.edu/id/eprint/9943

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