FIGURE 3-1 Conceptual model of health literacy.

FIGURE 3-1 Conceptual model of health literacy.

SOURCE: Baker (2006).

or smoking or use of alcohol or drugs? Is it a psychosocial factor? Is it a biological factor?

Some models of health disparities have been modified to examine health literacy and language as barriers to access to health care (Figure 3-2).

In a brief PubMed search using the terms health literacy and health disparities, Cooper said she identified 161 articles; 26 of them were reviews. Some studies were descriptive, comparing health literacy prevalence across disparity conditions. Others showed that disparities in health literacy between disparity populations and majority populations contributed to differences in access and quality of care. Fewer studies examined health literacy as a mediator of disparities in health outcomes. Far fewer studies looked at interventions being tested with low-literacy patients who also belonged to disparity populations to see if these interventions would reduce disparities.

It is interesting to note, Cooper said, that health disparities research has evolved in a manner similar to health literacy research. They both began by describing problems in different populations, then moved into



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