Health Literacy Within a Diverse Community-Based Cohort: The Multi-Ethnic Study of Atherosclerosis

Madison D. Anderson, Sharon Stein Merkin, Susan Everson Rose, Rachel Widome, Teresa Seeman, Jared W. Magnani, Carlos J. Rodriguez, Pamela L. Lutsey

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Background: Health literacy has yet to be described in a non-clinical, racially diverse, community-based cohort. Methods: Four questions assessing health literacy were asked during annual phone encounters with Multi-Ethnic Study of Atherosclerosis (MESA) participants between 2016 and 2018 (n = 3629). We used prevalence ratios (PRs) with 95% confidence intervals (CIs) to characterize how demographic and acculturation factors related to limited health literacy. Models adjusted for age, sex, and race/ethnicity, and race/ethnicity-stratified models were also examined. Results: Limited health literacy was prevalent in 15.4% of the sample. Participants who were older, female, lower-income, or less acculturated were at greater risk for having limited health literacy. Chinese, Hispanic, and Black participants were more likely than White participants to have limited health literacy. Patterns were similar when stratified by race/ethnicity. Discussion: Within MESA limited health literacy was common, particularly among Chinese and Hispanic participants, with some of the variance explained by differences in acculturation.

Original languageEnglish (US)
Pages (from-to)659-667
Number of pages9
JournalJournal of Immigrant and Minority Health
Issue number4
Early online dateNov 18 2020
StatePublished - Aug 2021

Bibliographical note

Publisher Copyright:
© 2020, Springer Science+Business Media, LLC, part of Springer Nature.


  • Acculturation
  • Health literacy
  • Risk factors


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