Monday, November 21, 2011

Literacy Affects Health

Higher Mortality

Low health literacy is significantly associated with higher mortality in patients with heart failure. This is the conclusion drawn by researchers who designed a retrospective study of patients at Kaiser Permanente in Colorado.

They examined cases of heart failure from 2001 to 2008, surveying patients by mail.  The patients were also followed for a median of 1.2 years.  Health literacy was assessed using well-established screening questions and categorized as either “adequate” or “low”.  Then researchers looked at hospitalization and mortality for all causes.

The survey response rate was 72% (1547 of 2156); 17.5% of responders had low health literacy.  Low health literacy was associated with:
  • Increased age
  • Lower socioeconomic status
  • Less likelihood of having at least a high school education
  • Higher rates of co-morbidities 
In multivariable Cox regression, low health literacy was independently associated with higher mortality (unadjusted rate, 17.6% vs 6.3%; adjusted hazard ratio, 1.97 [95% confidence interval, 1.3-2.97]; P = .001), but not hospitalization (unadjusted rate, 30.5% vs 23.2%; adjusted hazard ratio, 1.05 [95% confidence interval, 0.8-1.37]; P = .73).

This study was published in the Journal of the American Medical Association (JAMA.  2011; 305(16):1695-701 (ISSN: 1538-3598).

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