Health-Related Quality of Life and Health Literacy Among Primarily Hispanic Youth in a Southern Border State

Background and Purpose:

Although advances in the social and medical sciences have contributed to Americans living longer, healthier lives, achieving health equity continues to be a seemingly insurmountable task due to social, economic, and environmental disparities. Some of the most dramatic disparities are found within ethnic minority communities, including among Hispanics from border regions of the Southern United States. One of the more recent efforts underway to reduce health disparities is to understand and improve the health literacy (HL) and health-related quality of life (HRQoL) of high-risk populations. Despite the recognized importance and initial efforts to study and improve HL and HRQoL, there is a paucity of studies looking at these issues among Hispanic youth. The purpose of this study was to better understand the HL and HRQoL of diverse youth living in a majority Hispanic city in a Southern state near the Mexican border.

Methods:

Following IRB approval, researchers collaborated with three after-school programs to recruit high school aged youth (N=102; 55.7% Hispanic; female=56%; M age=15.89; SD=1.54) Youth completed the Pediatric Quality of Life assessment (HRQoL; 23 items), measuring youth’s physical and psychosocial health, and were administered two HL oral assessments. The first, The Newest Vital Sign (NVS; 6 items), evaluates reading comprehension and application of basic math concepts to health information using an ice cream label, ranking students’ degree of HL (“Adequate” to “High likelihood of limited HL”). The second, the Rapid Estimate of Adolescent Literacy in Medicine (REALM-Teen) has participants pronounce 66 health-related words (e.g., pill, exercise, depression), with the number of correctly pronounced words corresponding to grade-school reading level.

Results:

The REALM-Teen found that most students (65%) were reading below their grade level, with many (15%) reading at a 5^th grade level or lower. The NVS further indicated that nearly one-third of participants were highly likely to have limited HL. Findings from the HRQoL assessment were also consistent, with more than one-third of youth deemed to be “at-risk”; 21% at-risk within the physical sub-category, and over half at-risk within the psychosocial domain. Together, findings paint a multi-faceted and consistent portrayal of adolescent risk in these domains.

Conclusions and Implications:

Adolescence is a key developmental time period in the prioritization of health as the individual begins to gain autonomy and form an individual identity. Youth learn to do this through support from their families and communities, although those sampled indicated psychosocial risk. Further, our findings indicate that the youth sampled would have difficulty reading commonly utilized health language, and understanding basic health information to take care of their bodies. Where parents lack HL and social, emotional, or physical well-being, youth need other providers to deliver support and information. Furthermore, creating or expanding outreach health service efforts via additional support and funding from local, state, or federal reserves is needed. In view of the serious health disparities negatively impacting ethnic minority populations, improving HL and HRQoL should be both a local and national priority.