Appraising Health Literacy Among Vascular Surgery Patients
Amin A Mirzaie, Nancy C Hanson, Carlos Valdes, Christopher R Jacobs, Scott A Berceli, Salvatore T Scali, Martin R Back, Thomas S Huber, Gilbert R Upchurch, Samir K Shah
University of Florida, Gainesville, FL
INTRODUCTION: Health literacy is important both because it is a crucial aspect of informed decision-making and because poor health literacy has been associated with worse healthcare outcomes. To date, health literacy status has not been examined in vascular surgery. Therefore, we sought to determine the prevalence and factors associated with poor health literacy in vascular surgery patients. METHODS: The Newest Vital Sign (Pfizer, New York, NY), a validated instrument, was used to appraise the health literacy of 150 patients who visited the outpatient vascular clinic at UF Health Shands Hospital between April 2022 and August 2022. Patients who scored a 4 (out of 6) or higher were classified as having adequate health literacy. Patients with lower scores were classified as having poor health literacy. Each study subject also completed a demographic questionnaire. All statistical analysis was conducted using R (R Foundation for Statistical Computing, Vienna, Austria). RESULTS: 82 out of the 150 (54.6%) patients we screened had poor health literacy with a median Newest Vital Sign score of 3 (out of 6). Health literacy varied significantly with age (60.4 vs. 66.7 years for adequate and poor, p=.004) and years of formal education (14.4 vs. 12.5 years for adequate and poor, p=.001) (Table 1). Other demographic variables associated with poor health literacy were insurance status (p=.014), employment status (p=.008), and African American race (p=.002). 83% of African American patients had poor health literacy, while only 49% of Asian and White patients did. There was no association between procedure type and health literacy status. CONCLUSIONS: Most vascular surgery patients have poor health literacy. Increased age, fewer years of education, non-private insurance, employment status, and race are associated with poor health literacy. It is imperative that healthcare providers working with vascular surgery patients understand the poor health literacy of this patient population. Tailored and simplified communication about healthcare should be employed for vascular surgery patients with lower health literacy.
| Total (n=150) | Adequate HL (n=68) | Poor HL (n=82) | p-value | |
| Mean Age (Years) | 63.97 | 60.4 | 66.7 | .004 |
| Mean Education (Years) | 13.6 | 14.4 | 12.5 | .001 |
| Sex: | .107 | |||
| Male | 77 (51) | 30 (44) | 47 (57) | |
| Female | 73 (49) | 38 (56) | 35 (43) | |
| Race: | .002 | |||
| White/Asian | 126 (84) | 64 (94) | 62 (76) | |
| African American | 24 (16) | 4 (6) | 20 (24) |
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