Andrew J. Knighton|Kimberly D. Brunisholz|Samuel T. Savitz
Detecting Risk of Low Health Literacy in Disadvantaged Populations Using Area-based Measures
Intermountain Healthcare|Intermountain Healthcare|University of North Carolina at Chapel Hill
socioeconomic status ses low health literacy lhl closely correlated directly associated clinical behavioral risk factors healthcare outcomes learning healthcare systems introducing smallarea measures address challenges associated maintaining patientreported measures ses lhl studys purpose measure association two available census block measures associated ses lhl understanding relationship guide identification multipurpose area based measure delivery system usea retrospective observational design deployed using us census block groups utah principal dependent variable nationallystandardized health literacy score hls primary explanatory variable statestandardized area deprivation index adi statistical methods included linear regression tests association receiver operating characteristic roc analysis used develop lhl criteria using adia significant negative association hls adi score remained adjusting arealevel risk factors 021 95 ci 022 019 p 001 eighteen block groups 1 identified lhl using hls combination three adi components correlated lhl predicted 78 hls lhl block groups 35 additional block groups identified using hls cstatistic 064 95 ci 062 066hls adi use differing measurement criteria closely correlated statebased adi detected additional neighborhoods risk lhl compared use national hls adi represents multipurpose area measure social determinants useful learning health systems tailoring care