Examining Various Age Groups and Ethnicities as Potential At-Risk Populations for Low Health Literacy

Student Author(s)

Samantha Stevenson

Faculty Mentor(s)

Dr. Emilie Dykstra Goris, PhD, RN, Hope College Department of Nursing, Susanne Brooks, MSN, BS, RN, ACCNE_AG, Spectrum Health

Document Type


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Levels of health literacy have been shown to be indicators of patients’ future health outcomes. Low health literacy levels have been linked to poor self-care following hospitalization, difficulties in following medical instructions, and increased hospitalizations. The purpose of this study was to identify potential at-risk populations in order to improve patient education and health literacy. The Health Literacy Framework was used as a foundation to this study to show the link between literacy and patients’ abilities in health contexts. This study was a prospective, descriptive study which used a demographic survey asking questions such as ethnicity and year of birth and the Short-Form Test of Functional Health Literacy in Adults (S-TOFHLA). Using random stratified sampling, 290 participants were selected from a teaching hospital in the Midwest. Of those participants, 237 were white and 32 were non-white. There were 99 participants who were born before 1945, 109 between 1946-1964, 43 between 1965-1983, and 18 after 1984. The data were analyzed using SPSS software version 23. A Mann-Whitney test found that there was not a significant relationship between health literacy and ethnicity (U = 3678, p = 0.743). A Kruskal-Wallis H test found that there was a significant relationship between health literacy and age (χ2 = 33.271, p = .000). These results show that health literacy can be related to age, but not to ethnicity. Limitations for this study include exclusion of non-English speakers, a homogenous population, conducted at a single site, and possible skewed data due to patients with low health literacy declining to participate. Implications of the findings include identification of at-risk populations with low health literacy, in an effort to improve patient education and health outcomes.


This research was supported by Spectrum Health.

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