A Mixed-Method Analysis of Health Literacy Among Youth in Michoacan, Mexico

Background and Purpose:

Limited health literacy (HL) is strongly linked to negative physical and mental health outcomes, including increased hospital visits, higher health care costs, and poor adherence to care plans. In an effort to promote better HL in future generations, research on adolescent HL is now exploring its association with the use of preventative care and positive health behaviors. Youth who practice preventative healthcare have higher social, economic, education, and health outcomes than those who do not, which suggests HL and positive health behaviors are essential to strong adolescent development. As increasing access to preventative healthcare and promoting preventative health behaviors may increase HL, and vice versa, exploring both in the context of the world’s most vulnerable populations is one step in improving global health. While some research on youth HL has been conducted in Mexico, no studies have considered how preventative healthcare in Mexico may be associated to adolescent HL rates, or how promoting preventative care may serve to increase HL.

Methods:

Youth attending a middle school in rural Michoacán, Mexico were recruited to participate in a mixed-method study on health that took place during a typical school day. The authors collaborated with a Mexican research team (led by a school psychologist), who discussed the study and disseminated informed consent documentation to the parents of each student (N = 112; female = 48%; mean age = 13.2; response rate = 95%). Quantitative health literacy data was collected using the Newest Vital Sign measure, and eight focus groups were held (3 with boys, 5 with girls).

Results:

Results from the Newest Vital Sign measure indicated that 64% of students had a high likelihood of - or the possibility of - limited health literacy, compared to 36% who scored in the health literate range. A thematic analysis of focus group data identified four major barriers to preventative healthcare: 1) embarrassment, 2) going to the doctor only when sick, 3) going to family members with health concerns instead of the doctor, and 4) systemic problems regarding customer service and client privacy in the local healthcare clinic.   

Conclusions and Implications:

The World Health Organization (WHO) estimates that in 2015 over 1.2 million youth died mainly from treatable causes, making research on increasing preventative health behaviors imperative for improving the health of the world’s youth. Our case study suggests there may be a connection between low HL and limited preventative health behaviors among youth in Michoacán, Mexico. Although some of the barriers to preventative healthcare were more systematic in nature—which are important to be addressed at a policy level—increasing the HL of both the youth and their caregivers through health classes and educational campaigns may be able to reduce embarrassment and other barriers youth face in going to see a doctor. Further research on HL and preventative care may offer solutions to increase positive social, economic, education, and health outcomes of youth.