Who has low health literacy and does it matter for depression? Findings from aggregated and disaggregated racial/ethnic groups

Anne Q. Zhou, Hee Yun Lee, Richard M. Lee

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


OBJECTIVES: Health literacy is an important factor related to health outcomes and, ultimately, health disparities. Of the research that has been done, results have been mixed, which may be a reflection of how previous research primarily explored these relationships within aggregated groups. Thus, the present study sought to fill this gap in literature by exploring the relationships between determinants, health literacy, and depression within both aggregated and disaggregated groups.

METHOD: Data from the 2007 California Health Interview Survey (CHIS) was used, which included information collected from 51,048 adult participants. A model of the determinants of health, health literacy, and depression was constructed based on Andersen's Model of Health Utilization and fit within both an aggregated ethnic/racial and immigration status group, as well as within disaggregated groups.

RESULTS: Results indicated that when comparing ethnic/racial groups, Latinx and AAPI groups had the lowest levels of health literacy. When comparing nativity groups, immigrants had lower health literacy levels than U.S.-born. Finally when looking at disaggregated groups, Latinx and AAPI immigrants had the lowest health literacy levels among all groups. Furthermore, health literacy determinants as well as the relationship between health literacy and depression differed depending on group demographics.

CONCLUSIONS: This suggests that aggregated data analyses may obscure nuanced within-group differences, highlighting the importance of exploring health literacy within disaggregated groups. The results can be used to help inform the development of intervention or prevention-based programs that seek to improve health literacy and depression. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Original languageEnglish (US)
Pages (from-to)73-81
Number of pages9
JournalCultural Diversity and Ethnic Minority Psychology
Issue number1
StatePublished - Jan 2019

Bibliographical note

Funding Information:
This research was funded by the Institute on Diversity, Equity, and Advocacy’s Multicultural Research Awards at the University of Minnesota, Twin Cities.

Publisher Copyright:
© 2019 APA, all rights reserved.


  • depression
  • disaggregated data
  • ethnic/racial minority
  • health disparity
  • health literacy
  • Ethnic Groups/statistics & numerical data
  • Depression/ethnology
  • Health Status Disparities
  • United States
  • Humans
  • Middle Aged
  • Male
  • California
  • Health Surveys
  • Adolescent
  • Health Literacy/statistics & numerical data
  • Adult
  • Emigrants and Immigrants/psychology
  • Female
  • Health Status
  • Social Determinants of Health/ethnology

PubMed: MeSH publication types

  • Journal Article


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