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Assessing the Prevalence and Association of Acculturation and Health Literacy Levels in Spanish-Speaking Hispanic Patients at Midwestern Community Health Centers in the USA

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Abstract

Background

Predictions from the US census indicate that by 2060 one of every three individuals living in the nation will be of Hispanic origin. Hispanics experience health disparities manifested with higher rates of chronic conditions such as hypertension and diabetes in contrast with other US population groups. Health literacy and acculturation have been well identified as key contributors for this issue. However, very few studies have examined the association between health literacy and levels of acculturation in Spanish-speaking Hispanics living in rural and urban areas of the USA.

Objective

To assess the prevalence and association of acculturation with low levels of health literacy and demographic variables in Spanish-speaking Hispanics in the US Midwest.

Methods

We measured levels of acculturation in Spanish-speaking adult Hispanics (N = 401) accessing community health centers in rural and urban Nebraska. We used a survey that included the Bidimensional Acculturation Scale for Hispanics/Linguistic Proficiency Subscale (BAS/LP) and the Short Assessment of Health Literacy in Spanish (SAHL-S).

Results

We observed similar acculturation levels with rural and urban status participants. A total of 85% of the total participants had low levels of acculturation to US culture. Of the 15% of the participants who showed themselves to be bicultural, 81% reported adequate levels of health literacy in Spanish.

Conclusions

Our findings are consistent with previous studies that report the associations between acculturation and health literacy levels are significant. This study underscores the importance of considering the cultural aspects of the Hispanic community for the development of health literacy interventions and education programs.

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Acknowledgments

This project was supported in part by an appointment to the ORISE Research Participation Program at the Center for Drug Evaluation and Research administered by the Oak Ridge Institute for Science and Education through an agreement between the U.S. Department of Energy and CDER.

In addition, we want to express our gratitude to the OneWorld Community Health Centers, Inc. (Omaha, NE) and Good Neighbor Community Health Center (Columbus, NE) for allowing us to conduct this study in their facilities.

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Authors and Affiliations

  1. Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE, 68198-4373, USA

    Armando De Alba, Denise H. Britigan & Patrik Johansson

  2. Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA

    Elizabeth Lyden

Authors
  1. Armando De Alba
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  2. Denise H. Britigan
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  3. Elizabeth Lyden
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  4. Patrik Johansson
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Corresponding author

Correspondence to Armando De Alba.

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We have no conflict of interest to declare. This research study received institutional review (IRB) approval from the University of Nebraska Medical Center. We warrant that informed consent was obtained from all individual participants included in the study. All co-authors have both contributed substantially to the paper and have approved the version being submitted.

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De Alba, A., Britigan, D.H., Lyden, E. et al. Assessing the Prevalence and Association of Acculturation and Health Literacy Levels in Spanish-Speaking Hispanic Patients at Midwestern Community Health Centers in the USA. J. Racial and Ethnic Health Disparities 6, 701–706 (2019). https://doi.org/10.1007/s40615-019-00568-x

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