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Abstract
Despite well-documented links between low health literacy, low rates of health insurance coverage, and poor health outcomes, there has been almost no research on the relationship between low health literacy and self-reported access to care. This study analyzed a large, nationally representative sample of community-dwelling adults ages 50 and older to estimate the relationship between low health literacy and self-reported difficulty obtaining care. We found that individuals with low health literacy were significantly more likely than individuals with adequate health literacy to delay or forgo needed care or to report difficulty finding a provider, even after we controlled for other factors, including health insurance coverage, employment, race/ethnicity, poverty, and general cognitive function. They were also more likely to lack a usual source of care, although this result was only marginally significant after we controlled for other factors. The results show that in addition to any obstacles that low health literacy creates within the context of the clinical encounter, low health literacy also reduces the probability that people get in the door of the health care system in a timely way.
Acknowledgments
Preliminary results from this analysis were presented at the 5th Health Literacy Annual Research Conference, October 28–29, 2013, in Washington, DC.
Funding
Helen Levy acknowledges financial support from the National Institute on Aging (Grant No. NIA K01AG034232). The data used in this study were from the Health and Retirement Study, which is sponsored by the National Institute on Aging (Grant No. NIA U01AG009740) and conducted by the University of Michigan.