Paola Torres, Judith Guitelman, Araceli Lucio, Christine Rini, Yamilé Molina
Medical Advocacy among Latina Women Diagnosed with Breast Cancer
International journal of environmental research and public health
background approximately 80 million americans limited health literacy puts greater risk poorer access care poorer health outcomes purpose update 2004 systematic review determine whether low health literacy related poorer use health care outcomes costs disparities health outcomes among persons ages data sources englishlanguage articles identified medline cinahl psycinfo eric cochrane library databases handsearching search dates articles health literacy 2003 22 february 2011 articles numeracy 1966 22 february 2011 study selection two reviewers independently selected studies compared outcomes differences directly measured health literacy numeracy levels data extraction one reviewer abstracted article information evidence tables second reviewer checked information accuracy two reviewers independently rated study quality using predefined criteria investigative team jointly graded overall strength evidence data synthesis 96 relevant good fairquality studies 111 articles identified 98 articles health literacy 22 numeracy 9 low health literacy consistently associated hospitalizations greater use emergency care lower receipt mammography screening influenza vaccine poorer ability demonstrate taking medications appropriately poorer ability interpret labels health messages among elderly persons poorer overall health status higher mortality rates poor health literacy partially explains racial disparities outcomes reviewers could reach firm conclusions relationship numeracy health outcomes studies inconsistent results among studies limitations searches limited articles published english medical subject heading terms exist identifying relevant studies evidence concerning oral health literacy speaking listening skills outcomes found conclusion low health literacy associated poorer health outcomes poorer use health care services primary funding source agency healthcare research quality