Health literacy explains racial disparities in diabetes medication adherence
- PMID: 21951257
- PMCID: PMC3561717
- DOI: 10.1080/10810730.2011.604388
Health literacy explains racial disparities in diabetes medication adherence
Abstract
Although low health literacy and suboptimal medication adherence are more prevalent in racial/ethnic minority groups than Whites, little is known about the relationship between these factors in adults with diabetes, and whether health literacy or numeracy might explain racial/ethnic disparities in diabetes medication adherence. Previous work in HIV suggests health literacy mediates racial differences in adherence to antiretroviral treatment, but no study to date has explored numeracy as a mediator of the relationship between race/ethnicity and medication adherence. This study tested whether health literacy and/or numeracy were related to diabetes medication adherence, and whether either factor explained racial differences in adherence. Using path analytic models, we explored the predicted pathways between racial status, health literacy, diabetes-related numeracy, general numeracy, and adherence to diabetes medications. After adjustment for covariates, African American race was associated with poor medication adherence (r = -0.10, p < .05). Health literacy was associated with adherence (r = .12, p < .02), but diabetes-related numeracy and general numeracy were not related to adherence. Furthermore, health literacy reduced the effect of race on adherence to nonsignificance, such that African American race was no longer directly associated with lower medication adherence (r = -0.09, p = .14). Diabetes medication adherence promotion interventions should address patient health literacy limitations.
Figures
![Figure 1](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/3561717/bin/nihms436237f1.gif)
![Figure 2](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/3561717/bin/nihms436237f2.gif)
![Figure 3](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/3561717/bin/nihms436237f3.gif)
Similar articles
-
Medication Adherence Does Not Explain Black-White Differences in Cardiometabolic Risk Factor Control among Insured Patients with Diabetes.J Gen Intern Med. 2016 Feb;31(2):188-195. doi: 10.1007/s11606-015-3486-0. J Gen Intern Med. 2016. PMID: 26282954 Free PMC article.
-
Racial differences in medication adherence: A cross-sectional study of Medicare enrollees.Am J Geriatr Pharmacother. 2010 Apr;8(2):136-45. doi: 10.1016/j.amjopharm.2010.03.002. Am J Geriatr Pharmacother. 2010. PMID: 20439063 Free PMC article.
-
Numeracy skills explain racial differences in HIV medication management.AIDS Behav. 2010 Aug;14(4):799-806. doi: 10.1007/s10461-009-9604-4. Epub 2009 Aug 8. AIDS Behav. 2010. PMID: 19669403 Free PMC article.
-
Disparities in hypertension and cardiovascular disease in blacks: The critical role of medication adherence.J Clin Hypertens (Greenwich). 2017 Oct;19(10):1015-1024. doi: 10.1111/jch.13089. Epub 2017 Aug 30. J Clin Hypertens (Greenwich). 2017. PMID: 28856834 Free PMC article. Review.
-
Update on health literacy and diabetes.Diabetes Educ. 2014 Sep-Oct;40(5):581-604. doi: 10.1177/0145721714540220. Epub 2014 Jun 19. Diabetes Educ. 2014. PMID: 24947871 Free PMC article. Review.
Cited by
-
A Health Literacy-Focused Self-Management Intervention for African Americans with High Blood Pressure: A Pilot Randomized Controlled Trial.Int J Nurs Health Care Sci. 2022;2(14):173. Epub 2022 Dec 20. Int J Nurs Health Care Sci. 2022. PMID: 38770394 Free PMC article.
-
Relative predictive value of sociodemographic factors for chronic diseases among All of Us participants: a descriptive analysis.BMC Public Health. 2024 Feb 8;24(1):405. doi: 10.1186/s12889-024-17834-1. BMC Public Health. 2024. PMID: 38326799 Free PMC article.
-
Disparities in diabetes prevalence and management by race and ethnicity in the USA: defining a path forward.Lancet Diabetes Endocrinol. 2023 Jul;11(7):509-524. doi: 10.1016/S2213-8587(23)00129-8. Epub 2023 Jun 22. Lancet Diabetes Endocrinol. 2023. PMID: 37356445 Free PMC article. Review.
-
Ethnic disparities in medication adherence? A systematic review examining the association between ethnicity and antidiabetic medication adherence.PLoS One. 2023 Feb 22;18(2):e0271650. doi: 10.1371/journal.pone.0271650. eCollection 2023. PLoS One. 2023. PMID: 36812177 Free PMC article.
-
Cross-Cultural Adaptation and Validation of the Functional, Communicative and Critical Health Literacy Instrument (FCCHL-SR) for Diabetic Patients in Serbia.Healthcare (Basel). 2022 Aug 31;10(9):1667. doi: 10.3390/healthcare10091667. Healthcare (Basel). 2022. PMID: 36141279 Free PMC article.
References
-
- Cavanaugh K, Huizinga MM, Wallston KA, Gebretsadik T, Shintani A, Davis D, et al. Association of numeracy and diabetes control. Annals of Internal Medicine. 2008;148(10):737–746. - PubMed
-
- Davis TC, Wolf MS, Bass PF, 3rd, Thompson JA, Tilson HH, Neuberger M, et al. Literacy and misunderstanding prescription drug labels. Annals of Internal Medicine. 2006;145(12):887–894. - PubMed
Publication types
MeSH terms
Grants and funding
LinkOut - more resources
Full Text Sources
Medical