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The Association of Acculturation and Health Literacy, Numeracy and Health-Related Skills in Spanish-speaking Caregivers of Young Children

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Abstract

Little is known about the relationship among acculturation, literacy, and health skills in Latino caregivers of young children. Latino caregivers of children < 30 months seeking primary care at four medical centers were administered measures of acculturation (SASH), functional health literacy (STOFHLA), numeracy (WRAT-3) and health-related skills (PHLAT Spanish). Child anthropomorphics and immunization status were ascertained by chart review. Caregivers (N = 184) with a median age of 27 years (IQR: 23–32) participated; 89.1 % were mothers, and 97.1 % had low acculturation. Lower SASH scores were significantly correlated (P < 0.01) with lower STOFHLA (ρ = 0.21), WRAT-3 (ρ = 0.25), and PHLAT Spanish scores (ρ = 0.34). SASH scores predicted PHLAT Spanish scores in a multivariable linear regression model that adjusted for the age of child, the age and gender of the caregiver, number of children in the family, the type of health insurance of the caregiver, and study site (adjusted β: 0.84, 95 % CI 0.26–1.42, P = 0.005). This association was attenuated by the addition of literacy (adjusted β: 0.66, 95 % CI 0.11–1.21, P = 0.02) or numeracy (adjusted β: 0.50, 95 % CI −0.04–1.04, P = 0.07) into the model. There was no significant association between acculturation and up-to-date child immunizations or a weight status of overweight/obese. Lower acculturation was associated with worse health literacy and diminished ability to perform child health-related skills. Literacy and numeracy skills attenuated the association between acculturation and child health skills. These associations may help to explain some child health disparities in Latino communities.

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Acknowledgments

The authors would like to acknowledge the contribution to this study of Isabel S. Bazan, Maria E. Cerra, Campbell P. Cross, Collin Fuller, Joanne P. Hernandez, Alejandro Vanegas, Andrea Vanegas, Joanne Finkle, Brenda Calderon, Steven Pattishall, Kate Scott, Lisa Whitehead, Jessica Hart, Lourdes Q. Forster, Stephanie Prendes, Daniela Quesada, Khalil Harbi, and Patricia Paez. This research was supported with funding from the NICHD (R01 HD049794), and the Tennessee Department of Health Project Diabetes Initiative. This research was also supported in part by a grant under The Robert Wood Johnson Foundation Physician Faculty Scholars Program (Dr. Yin). Dr. Ciampa was supported by the Veteran’s Affairs Quality Scholars Fellowship Program. Dr. Perrin is supported by an NIH career development award (K23 HD051817). Funders had no role in study design, data collection and interpretation, manuscript preparation or the decision to submit the manuscript for publication.

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Authors and Affiliations

  1. Departments of Internal Medicine and Pediatrics, Vanderbilt University School of Medicine, 2525 West End Avenue, Suite 725, Nashville, TN, 37203-1738, USA

    Philip J. Ciampa & Russell L. Rothman

  2. Departments of Internal Medicine and Pediatrics, Meharry Medical College, Nashville, TN, USA

    Richard O. White

  3. Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC, USA

    Eliana M. Perrin

  4. Department of Pediatrics, New York University School of Medicine, New York, NY, USA

    H. Shonna Yin

  5. Department of Pediatrics, University of Miami School of Medicine, Miami, FL, USA

    Lee M. Sanders

  6. Vanderbilt University School of Medicine, Nashville, TN, USA

    Eryka A. Gayle

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  1. Philip J. Ciampa
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Correspondence to Philip J. Ciampa.

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Ciampa, P.J., White, R.O., Perrin, E.M. et al. The Association of Acculturation and Health Literacy, Numeracy and Health-Related Skills in Spanish-speaking Caregivers of Young Children. J Immigrant Minority Health 15, 492–498 (2013). https://doi.org/10.1007/s10903-012-9613-7

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  • DOI: https://doi.org/10.1007/s10903-012-9613-7

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