Statement of purpose Research has consistently shown that community-level socioeconomic (SES) indicators are associated with injury incidence and outcomes. Health literacy, perhaps the newest SES indicator, is the capacity to understand basic health information and make appropriate health decisions (Koh et al., Health Affairs, 2012). Health literate populations may be better equipped for good health outcomes due to their understanding of current health and prevention messages. The purpose of the analysis is to observe whether community characteristics are associated with inequalities in crash characteristics and outcomes.
Methods/Approach Using commercial marketing demographic data (Nielsen/Claritas) from the community level (including county, ZIP code, and Census tract), characteristics of the geographical area in which injury victims reside were obtained. Injury outcome and patient characteristics derived from hospital data were compared to community-level measures such as community demographics, socioeconomic factors and a health literacy score developed by the Centre for Health Promotion at the Minnesota Department of Health. ArcGIS was used for map overlays.
Results Analyses indicated an association (p = 0.05) between health literacy scores and rates of hospital-treated MV crashes at the county level. The r-square was relatively low (0.04) indicating additional multivariate analyses could better explain the variance of the outcome. Further analyses were performed with various community-level indicators, indicating similar associations with other types of injury, such as falls.
Conclusions Community-specific inequalities in crash characteristics and outcomes point to the need for more health literate or readily understandable signage as part of our transportation systems’ prevention efforts. Further, an emphasis on health literacy and other social determinants of health can be used in providing better, patient-centred hospital intervention and treatment to injury victims. Commercial marketing demographic data can be used to guide these prevention and intervention efforts.
Significance and contribution to the field The use of health literacy as an SES indicator in injury prevention and control analyses is a relatively new translation of research into public health practice. Similarly the use of commercial marketing demographic data, especially when used in the creation of health literacy indices, is also a relatively new practice.
Koh HK, Berwick DM, Clancy CM, et al. New federal policy initiatives to boost health literacy can help the nation move beyond the cycle of costly ‘crisis care’. Health Affairs 2012:31(2):434–43
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