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Link between health status, health literacy and Internet use among rural low income mothers

Kimberly Greder, Ph.D., Associate Professor and Extension Specialist, Department of Human Development & Family Studies

Iowa State University

Yoshie Sano, Ph.D., Assistant Professor, Department of Human Development, Washington State University- Vancouver

Sheila Mammen, Ph.D. Associate Professor, Department of Resource Economics, University of Massachusetts Amherst

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Health literacy The capacity to obtain, process, and

understand basic health information and services needed to make appropriate health

decisions (Ratzan & Parker 2000).

Health literacy Adult health status

• Years of formal schooling• Health status• Income/poverty level• Age• Race/ethnicity• Citizenship status• Reading practices• Civic behavior

Health literacy

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Who is most vulnerable for low health literacy?

People with less than a high school education

Racial/ethnic minorities

People who are over the age of 65

Rural residents

Low Health literacy Worse Health

• Poorer health choices• Riskier behaviors• Higher mortality• More hospitalizations• Higher health costs

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Internet usage increases social capital by facilitating communication with strong and weak social ties, across distance and time.

While most U.S. residents like online sources of health information, rural residents are less likely to report general Internet use or health-related Internet use. Potential reasons: lower education levels and less broadband access among rural residents

Conference theme: Partnerships to Improve the

Health of the Nation

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Wave 1: 186 familiesIA, MA, WA

http://ruralfamiliesspeak.org/

54%41%

2% 2% 1% Hispanic/Latino

Non-Hispanic White

African American

Native American

Multi-Racial

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6

0

10

20

30

40

50

60

70

8th grade or less Some high school High school/GED Technical training Some collegeincluding AA

College graduateand above

Num

ber

of m

othe

rs

Marital StatusSingle/Never married

Divorced/Widowed

Married

Living with Partner

18%

48%

11%

23%

53%47%

English

Spanish

Language of Interview

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What is the relationship between mothers who speak Spanish and mothers who speak English and their use of the Internet to find health information for themselves or their children?

What is the relationship between… •mothers’ health status and use of the Internet to find health information?•children’s health status and use of the Internet to find health information?

Do you use the Internet to find information about your or your child’s health?

0%

10%

20%

30%

40%

50%

60%

70%

For mother For child

Spanish

English

* Mothers who used the Internet for information about child’s health, rated child’s health status better .

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Where do you access the Internet most often?

0%

10%

20%

30%

40%

50%

60%

70%

Home Library Relative/Friend Work Other

SpanishEnglish

0

5

10

15

20

25

30

35

40

45

50

Excellent Very Good Good Fair Poor

Num

ber o

f mot

hers

English

Spanish

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9

0

5

10

15

20

25

30

35

Excellent Very good Good Fair

Num

ber o

f mot

hers

English

Spanish

0

10

20

30

40

50

60

Excellent Very Good Good Fair Poor

Num

ber o

f mot

hers

Internet users

Non-internetusers

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10

0

5

10

15

20

25

30

35

40

Excellent Very good Good Fair

Num

bero

f mot

hers

Internet users

Non-internetusers

How often do you need to have someone help you when you read instructions, pamphlets, or other written materials from your doctor, pharmacy, or insurance company?

0%10%20%30%40%50%60%70%80%

Never Sometimes Often

SpanishEnglish

*Children’s health was significantly related to needing assistance in reading print materials

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• How can you apply these findings to your work with rural, low-income families that have young children?

• What are you currently doing that you should continue to do?

• What could you do differently? • What additional research is needed?

• Print remains relevant option for providing health information• Hire/train bi-cultural, bi-lingual Latinos who understand

acculturation issues to design and deliver health education• Educational programs available in Spanish - minimum, an

interpreter available• Consent, program enrollment forms, promotional and program

materials reviewed or developed by people fluent in Spanish and English and who have a good understanding of Latino culture, acculturation issues, and principles/practices of effectively translating written information.

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• Training needed to…• recognize specific health literacy needs of ethnically/racially

diverse rural low income families• help families navigate health service systems

• Review forms/written activities and office signage to ensure information is understandable; ask families for feedback to improve forms.

• Review information you prepare for the media (radio psa’s, news articles) to ensure health literacy principles and practices are followed.

• Bring stakeholders, including low income families, together to learn how poor health literacy is detrimental to individual and population health. Brainstorm potential do-able action steps for families and the community.

• Explore rural low income mother’s preferences for receiving health information

• Explore effectiveness of the structure and design of health materials in prompting rural low income mothers to take specific actions to maintain or improve their health.