The impact of health and health insurance literacy on access to care for Hispanic/Latino communities

Jean Edward, Sarah Morris, Fatma Mataoui, Phillip Granberry, Mark V. Williams, Idali Torres

Research output: Contribution to journalArticlepeer-review

34 Scopus citations


Objectives: The aim of this study was to assess the impact of health literacy (HL) and health insurance literacy (HIL) on health insurance status and access to health care services for Spanish-speaking communities living in Massachusetts. Methods: A total of 139 surveys (descriptive, knowledge-based HIL questions, and Short Assessment of Health Literacy in Spanish) and 30 semi-structured interviews were collected and analyzed using chi-square, Mann-Whitney U test, and logistic regression analysis. Results: The majority of participants had inadequate HL (56%) and HIL (93%). There were differences in HL scores (t = 4.1; p <.0001) between the insured (M = 12.3, SD = 5.7) and uninsured (M = 7.9, SD = 6.7) and differences (t = 1.9; p =.05) between those with adequate HIL (M = 14.3, SD = 4.3) and inadequate HIL (M = 10.2, SD = 6.6). Participants who were uninsured (MW U = 37.6; p <.0001) and who had inadequate HL (MW U = 5.2; p =.02) were more likely to have never accessed health care in the U.S. Participants who had never accessed health care were 93% less likely to be insured and those with adequate HL were three times more likely to be insured. Conclusions: Health literacy and HIL are closely associated with insurance status and access to health care for Spanish-speaking communities, indicating the need for further research and enhanced public health efforts to improve knowledge and awareness around navigating health care systems.

Original languageEnglish
Pages (from-to)176-183
Number of pages8
JournalPublic Health Nursing
Issue number3
StatePublished - May 1 2018


  • Hispanics/Latinos
  • access to health care
  • health insurance
  • health literacy


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