Health Insurance Literacy and Low Wage Earners: Why Reading Matters

Health literacy is the ability of people to access, understand, and use health information (U.S. Department of Health and Human Services, 2010). Adults with low health literacy have low reading, numeracy, and digital skills which means that they have difficulty reading medication and discharge instructions, following instructions on a prescription bottle, using a table or chart to calculate their insurance deductibles, finding accurate health information on the Internet and/ or understanding the concept of risk (America’s Health Literacy: Why We Need Accessible Health Information, 2008; Bartholomae, Russell, Braun, & McCoy, 2016; Feinberg, Greenberg, & Frijters, 2015). Low health literacy is correlated with lower levels of educational attainment, higher use of non-print health information sources (radio or television), and less use of the Internet for accessing health information (Feinberg et al., 2015). Individual health literacy does not exist in a vaccum; rather, it is the interplay between one’s individual skills and the health literacy level of information that is provided that can further complicate how individuals access, understand, and use health information (Berkman, Davis, & McCormack, 2010; Rudd, 2015). Differences in culture, ethnicity, language, and social determinants of health such as socioeconomic status also affect an individual’s health literacy. Beliefs about health and health care, the meanings of words, access to health care, preferences of language and cultural beliefs all have a Abstract In the United States, worker health care is funded through health insurance plans paid for by employers. Insurance plans are written in complicated language that low wage earners (LWE), who have lower levels of education, may find difficult to understand. We examined the relationship between health insurance literacy (HIL), education, and literacy skills for 75 LWE. Results indicated low to moderate associations between literacies (reading, numeracy, digital), educational attainment and HIL; in a multiple regression analysis, only reading was uniquely significant. LWE with low educational attainment and poor reading skills may need additional support to understand and use their health insurance. Research Article