Parental Health Literacy Is Associated with Children's Health Outcomes: Is It True for All Racial/Ethnic Groups?

Background/Purposes: Low health literacy has been identified by previous research as an important factor linked to negative health outcomes, both in terms of individual health outcomes (Berkman, Sheridan, Donahue, Halpern, & Crotty, 2011) as well as the health outcomes of others. For example, research has found a significant relationship between parental health literacy and child health outcomes with lower health literacy related to worse outcomes, and this suggests that parents may act as a gatekeeper (DeWalt, et al., 2007) for their children’s health. Thus, in populations such as immigrant and ethnic minority populations, where there is greater risk of health literacy and high health disparities (Kreps & Sparks, 2008), there is a critical need to better understand the relationship between parental health literacy and child health outcomes.  However, there has been little research done exploring the link between parental health literacy and children’s health outcomes in these populations where there is a urgent need for such research. The present study aims to address this gap in literature by investigating the status of immigrant and US-born parents’ health literacy levels, as well as how their health literacy relates to their child’s health status.

Methods: This study utilized data from the 2007 California Health Interview Survey (CHIS) which oversampled Asian and Latino immigrant groups. Participants were 5,877 parents that were primarily non-Latino whites (60.5%), females (62.2%), married (77.1%), living in an Urban location (81.5%), and had an average age of 38.76 years (SD = 8.54). Their children were aged between 4 to 10 (M = 5.62, SD = 3.53) and were generally evenly split in terms of gender (51.8% male). The primary outcome was children’s physical health status and the independent variable was parental health literacy. To answer the research questions of interest, weighted univariate, bivariate, and multivariate analyses were conducted using STATA 12.0.

Findings: Results indicated Asian US-born and White US-born parents reported the highest levels of health literacy. Latino US-born, Latino Immigrant, and Asian Immigrant parents reported significantly lower health literacy levels than their Asian US-born and White US-born peers. Health literacy was a significant correlate of child health outcomes only for children of Latino US-born, Latino immigrant, and Asian immigrant parents such that higher parental health literacy was correlated with reports of better child health status. 

Conclusions: The results suggest that there are significant differences in health literacy levels between groups. Of interest was the heterogeneity in findings such that parental health literacy was not significantly related to child health for all groups. Rather, parental health literacy was significant only for the groups that reported lower parental health literacy levels. These findings give support to the urgent need to customize health literacy educational messages and future intervention strategies aimed to raise parental health literacy regarding their children in Latina US-born and immigrant parents, as well as Asian immigrant parents.