Health Literacy in an Underserved Immigrant Population: New Implications Toward Achieving Health Equity

This study investigated levels of health literacy and factors predicting health literacy among 407 Korean American immigrants living in New York City. The authors adopted the Andersen's Behavioral Model (Andersen, 1968, 1995) as the theoretical guide of the study, examining predisposing, enabling, and need factors for health literacy and used a 12-item health literacy scale adopted from Chew, Bradley, and Boyko's (2004) work. They categorized participants into 3 health literacy groups based on their level of understanding and effective use of given health information: inadequate, marginal, and adequate health literacy. More than 60% of the participants had inadequate (31.7%) or marginal (29.8%) levels of health literacy, indicating a lower level of health literacy in this immigrant group. The areas that those with an inadequate health literacy level struggled with were understanding written health care information and filling out medical forms at the clinics. Results from an ordinary least squares regression analysis revealed that the predisposing factors of being female and having a low level of modesty toward health care professionals were predictors in having higher levels of health literacy. Of enabling factors, higher level of English proficiency and education, and having a primary care physician were significant predictors of higher level of health literacy. None of the need factors were significantly associated with health literacy. This study highlights an urgent need for developing a community-based health literacy education program in immigrant communities, as well as to initiate staffing a health education worker at clinics to reduce health disparities among immigrants with limited health literacy.