Associations of Acculturation with English- and Spanish-Language Health Literacy Among Bilingual Latino Adults.

ABSTRACT

BACKGROUND: Low health literacy (HL) is associated with poor health status and outcomes. Racial/ethnic minorities in the United States disproportionately experience low HL and HL-related health disparities. Among Latinos, acculturation is associated with health outcomes, but little is known about the relationship between acculturation and HL. OBJECTIVE: We examined associations of sociodemographic and acculturation variables with English- and Spanish-language HL among 142 bilingual Latino adults with adequate HL. METHODS: HL was assessed in English using the Rapid Estimate of Adult Literacy in Medicine (REALM) and in Spanish with the Short Assessment of Health Literacy for Spanish-speaking Adults (SAHLSA). Acculturation was assessed using the four subscales of the Multidimensional Acculturation Scale-II. Associations of sociodemographic data and acculturation with HL were examined using linear regression. KEY RESULTS: Higher education, higher income, higher English proficiency, and lower Latino cultural identification predicted REALM scores (ps <.05) in univariate models. When these variables were entered into a single model, only education and Latino cultural identification were associated with REALM scores. In univariate analyses, the following characteristics were associated with SAHLSA scores female gender, being partnered, higher education, higher income, being non-US born, lower English proficiency, and higher Spanish proficiency (ps < .05). Education, being non-US born, English proficiency, and Spanish proficiency were each significant in the multivariate model. CONCLUSIONS: Results revealed a significant association between acculturation and English- and Spanish-language HL among bilingual Latino adults with adequate HL, suggesting that HL should be assessed in the language in which individuals are most proficient. HL assessed in a nonprimary language may be confounded with language proficiency. [HLRP Health Literacy Research and Practice. 2019;3(2)e81-e89.]. PLAIN LANGUAGE SUMMARY: The results of this investigation revealed a significant association between acculturation and English- and Spanish-language health literacy among bilingual Latino adults. This suggests that health literacy should be assessed in the language in which individuals are most proficient. Health literacy assessed in a nonprimary language may be influenced by language proficiency.