ArticleJournal of general internal medicine2023
Predicted Health Literacy Disparities Between Immigrant and US-Born Racial/Ethnic Minorities: a Nationwide Study.
Article in Journal of general internal medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Terminology and Definitions of Racial Health Equity in Prominent Health Websites: Systematic Review.Journal of medical Internet research · 2025Pooled it
- Health literacy and medication adherence in adults from ethnic minority backgrounds with Type 2 Diabetes Mellitus: a systematic review.BMC public health · 2025Pooled it
- Dietary and social predictors of PFAS exposure in Hispanic children from Northern Virginia.Journal of exposure science & environmental epidemiology · 2026Article
- Perception of care in immigrant and nonimmigrant persons with inflammatory bowel disease: a survey-based study.Journal of the Canadian Association of Gastroenterology · 2026Article
- Nativity and Cancer Information-Seeking Behaviors Among Middle-Aged and Older-Adults in the United States.Journal of racial and ethnic health disparities · 2026Article
- Enrollment Assister Perspectives of a Private Health Insurance Program for Undocumented Immigrants.JAMA health forum · 2026Article
- In-hospital Wait Times for Emergency General Surgery: Do Immigrants Wait Longer?Journal of immigrant and minority health · 2026Article
- A health literate evaluation of a reproductive health education program for young men with sickle cell disease.Journal of communication in healthcare · 2026Article
- Intersection of race and ethnicity with perceptions of health status and literacy in adult patients with spinal deformity: insights from the all of us research program.Spine deformity · 2026Article
- Article
- Social determinants of health and biological age among diverse U.S. Adults, NHANES 2011-2018.BMC public health · 2025Article
- Sociodemographic disparities in health literacy among American adults: A national survey study.Preventive medicine reports · 2025Article
- The forgotten - overcoming challenges in diabetes care for marginalized populations.Expert review of endocrinology & metabolism · 2025Review
- Screen-Related Parenting Practices in Mexican American Families with Toddlers: Development of Culturally- and Contextually-Relevant Scales.Children (Basel, Switzerland) · 2025Article
- Measuring attraction to screen devices in early childhood: development of the Affinity-TV and Affinity-Mobile scales.Frontiers in pediatrics · 2025Article
- A descriptive epidemiological study of the prevalence of self-reported sensory difficulties by age group, sex, education, disability, and migration status in Sweden in 2020.BMC public health · 2024Article
- Examining the differences of perceptions and experience with online health information accessibility between deaf and hearing individuals: A qualitative study.Patient education and counseling · 2024Article
- Article
- Health literacy and associated factors in China: findings from the Wa ethnic group.Frontiers in public health · 2024Article
- Improving cervical cancer health literacy in Arabic-speaking immigrant women in the United States through an online patient education tool.Women's health (London, England)Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRacial/ethnic minorities in the USA exhibit reduced health literacy (HL) proficiency, leading to increased health disparities. It is unclear how the effect of birth status (immigrant/US-born) affects HL proficiency among racial/ethnic minorities.
objectiveTo identify the direct, indirect, and total effects of birth status on HL proficiency among a nationally representative population of racial/ethnic minority adults in the USA.
designA cross-sectional study of 2019 data from the Medial Expenditure Panel Survey.
participantsParticipants aged 18 or older reporting as racial/ethnic minorities (Black, Asian, or Hispanic) with non-missing data. MAIN MEASURES: We predicted HL proficiency for each participant using a previously published model. Path analysis was used to estimate the direct, indirect, and total effects of birth status on HL proficiency, accounting for several other covariates. Prevalence ratios were estimated using adjusted Poisson regression to evaluate differences in the "Below Basic" HL category. KEY
resultsAn estimated weighted 81,092,505 participants were included (57.5% US-born, 42.5% immigrant). More racial/ethnic minority immigrant participants fell into the lowest category of HL proficiency, "Below Basic" (14.3% vs 5.5%, p < 0.05). Results of the path analysis indicated a significant, negative direct effect of birth status on HL proficiency (standardized coefficient = - 0.24, SE = 0.01, 95%CI: - 0.26, - 0.23) in addition to an indirect effect mediated through insurance status, health-system resource use, and English proficiency. The total effect of birth status on HL proficiency was found to be - 0.29. The immigrant participant group had 81% higher prevalence of falling into the "Below Basic" HL category compared to US-born participants (prevalence ratio = 1.81, 95%CI: 1.52, 2.16).
conclusionsImmigrant status has a strong, negative, direct effect on HL proficiency among racial/ethnic minorities in the USA. This may be a result of barriers that prevent equitable access to resources that improve proper HL proficiency. US policymakers may consider several methods to reduce this disparity at the health-system-, provider-, and patient-levels.
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