Neighborhood characteristics and health literacy: Evidence from the survey of racism and public health

Abstract

Objectives

Limited research exists on the relationship between neighborhood characteristics and health literacy. We investigated the potential impacts of neighborhood characteristics on health literacy and explored whether these associations varied across racial/ethnic groups.

Study design

The study was a web-based cross-sectional study of adults (18+ years old) residing in areas within the US Health and Human Services Regions 1, 2, or 3.

Methods

The 2023 Survey of Racism and Public Health dataset was linked with the 2017–2021 American Community Survey dataset using the respondents' zip codes to obtain measures of residential segregation, neighborhood deprivation, racial and economic polarization, and racial and educational isolation. The Brief Health Literacy Screen was used to assess participants' health literacy. Unadjusted and adjusted models were employed to explore the associations between neighborhood characteristics and limited health literacy.

Results

Of 4948 participants, the mean age was 47 (SD = 17) years, 48 % were White, and 42 % had college degrees or higher. Greater neighborhood deprivation was associated with an increased likelihood of limited health literacy (aOR = 1.12, 95 % CI: 1.01, 1.24). Higher racial and economic polarization was associated with decreased odds of limited health literacy (aOR = 0.83, 95 % CI: 0.73, 0.93). Increased racial isolation is associated with increased odds of limited health literacy (aOR = 1.31, 95 % CI:1.14,1.50). These associations did not significantly vary by racialized/ethnic groups.

Conclusions

Incorporating neighborhood characteristics in health literacy research helps reveal a possible critical key risk factor; higher neighborhood deprivation increases the likelihood of limited health literacy with no variation across the racial/ethnic groups within the same neighborhood. The findings point policymakers toward the direction for intervention in policy changes that will reduce the maldistribution of health—and economic-promoting resources and risky life-course exposures in communities to improve public health literacy.