Screening for health literacy, social determinants, and discrimination in health plans.

OBJECTIVES: Health inequities are frequently driven by social determinants of health (SDOH) and structural determinants of health. Our pilot sought to test the feasibility of screening for health literacy (HL) and perceived health care discrimination (PHD) through a live telephonic-facilitated survey experience with managed care patients. STUDY DESIGN: Cross-sectional study. METHODS: Newly enrolled Medicare Advantage patients were screened for self-reported PHD, HL, and multiple SDOH using validated screening tools. Response rates for both HL and PHD screens were analyzed. A χ2 test for association between response to PHD screen and patient race was conducted. A weighted logistic regression model was used to understand how HL is associated with SDOH and demographic factors (age, gender, race/ethnicity, and income). RESULTS: HL and PHD screening questions have different levels of feasibility. Administering the HL screen did not present a challenge, and patients felt comfortable responding to it. On the other hand, the PHD question had a lower response rate among patients, and some concierge advocates felt uncomfortable asking patients the question. Based on the self-reported HL data collected, low/limited HL is associated with patients who were Black, were low income, reported loneliness or isolation, or reported food insecurity. It is important to note that the study's findings are limited by the small sample size and that study results do not imply causality. CONCLUSIONS: It is feasible to collect self-reported HL data through a live telephonic format at the time of patient enrollment into a health plan. Health plans can leverage such screenings to better understand patient barriers for health equity-oriented interventions.

Assessing Anxiety and Depression Among Students Post-COVID-19: Exploring Associating Factors.

Background: The COVID-19 pandemic has had a large impact on global mental health including anxiety and depression rates, many factors affected the vulnerability to these psychological conditions amongst university students. Aim: To explore the level of anxiety and depression of university students living in Jordan. Methods: A cross-sectional study design was conducted in which an electronic survey was created and distributed, university students residing in Jordan participated in the study. Results: A total of 1241 students were enrolled in the study. The mean anxiety score among males and females was (9.68 (SD = 4.10)) and (10.46 (SD = 4.14)), respectively. 42.1% of males had "abnormal" anxiety score compared to 48.4% females. The mean depression score among males (7.77 (SD = 4.31)) was similar to that for the females (7.64 (SD = 4.14)), and 26.0% of the males had "abnormal" depression score compared to 22.6% of the females. Factors affecting anxiety scores included younger age, being a female, taking medication/s, or drinking two cups of coffee or more a day. Conclusion: With 46% and 24% of students suffering from abnormal anxiety and depression respectively, it is important for education policy makers to take immediate measures to allocate students in need of psychological assessment and help to deliver suitable interventions.