Caregivers' health literacy and gaps in children's Medicaid enrollment: findings from the Carolina Oral Health Literacy Study.
Recent evidence supports a link between caregivers' health literacy and their children's health and use of health services. Disruptions in children's health insurance coverage have been linked to poor health care and outcomes. We examined young children's Medicaid enrollment patt...
Main Authors: | , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Public Library of Science (PLoS)
2014-01-01
|
Series: | PLoS ONE |
Online Access: | http://europepmc.org/articles/PMC4193870?pdf=render |
id |
doaj-feb4af68bb304e719ddf7073cc7ab6bf |
---|---|
record_format |
Article |
spelling |
doaj-feb4af68bb304e719ddf7073cc7ab6bf2020-11-25T02:06:06ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-01910e11017810.1371/journal.pone.0110178Caregivers' health literacy and gaps in children's Medicaid enrollment: findings from the Carolina Oral Health Literacy Study.Jessica Y LeeKimon DivarisDarren A DeWaltA Diane BakerZiya GizliceR Gary RozierWilliam F VannRecent evidence supports a link between caregivers' health literacy and their children's health and use of health services. Disruptions in children's health insurance coverage have been linked to poor health care and outcomes. We examined young children's Medicaid enrollment patterns in a well-characterized cohort of child/caregivers dyads and investigated the association of caregivers' low health literacy with the incidence of enrollment gaps.We relied upon Medicaid enrollment data for 1208 children (mean age = 19 months) enrolled in the Carolina Oral Health Literacy project during 2008-09. The median follow-up was 25 months. Health literacy was measured using the Newest Vital Sign (NVS). Analyses relied on descriptive, bivariate, and multivariate methods based on Poisson modeling.One-third of children experienced one or more enrollment gaps; most were short in duration (median = 5 months). The risk of gaps was inversely associated with caregivers' age, with a 2% relative risk decrease for each added year. Low health literacy was associated with a modestly elevated risk increase [Incidence Rate Ratio (IRR) = 1.17 (95% confidence interval (CI) 0.88-1.57)] for enrollment disruptions; however, this estimate was substantially elevated among caregivers with less than a high school education [IRR = 1.52 (95% CI 0.99-2.35); homogeneity p<0.2].Our findings provide initial support for a possible role of caregivers' health literacy as a determinant of children's Medicaid enrollment gaps. Although the association between health literacy and enrollment gaps was not confirmed statistically, we found that it was markedly stronger among caregivers with low educational attainment. This population, as well as young caregivers, may be the most vulnerable to the negative effects of low health literacy.http://europepmc.org/articles/PMC4193870?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jessica Y Lee Kimon Divaris Darren A DeWalt A Diane Baker Ziya Gizlice R Gary Rozier William F Vann |
spellingShingle |
Jessica Y Lee Kimon Divaris Darren A DeWalt A Diane Baker Ziya Gizlice R Gary Rozier William F Vann Caregivers' health literacy and gaps in children's Medicaid enrollment: findings from the Carolina Oral Health Literacy Study. PLoS ONE |
author_facet |
Jessica Y Lee Kimon Divaris Darren A DeWalt A Diane Baker Ziya Gizlice R Gary Rozier William F Vann |
author_sort |
Jessica Y Lee |
title |
Caregivers' health literacy and gaps in children's Medicaid enrollment: findings from the Carolina Oral Health Literacy Study. |
title_short |
Caregivers' health literacy and gaps in children's Medicaid enrollment: findings from the Carolina Oral Health Literacy Study. |
title_full |
Caregivers' health literacy and gaps in children's Medicaid enrollment: findings from the Carolina Oral Health Literacy Study. |
title_fullStr |
Caregivers' health literacy and gaps in children's Medicaid enrollment: findings from the Carolina Oral Health Literacy Study. |
title_full_unstemmed |
Caregivers' health literacy and gaps in children's Medicaid enrollment: findings from the Carolina Oral Health Literacy Study. |
title_sort |
caregivers' health literacy and gaps in children's medicaid enrollment: findings from the carolina oral health literacy study. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2014-01-01 |
description |
Recent evidence supports a link between caregivers' health literacy and their children's health and use of health services. Disruptions in children's health insurance coverage have been linked to poor health care and outcomes. We examined young children's Medicaid enrollment patterns in a well-characterized cohort of child/caregivers dyads and investigated the association of caregivers' low health literacy with the incidence of enrollment gaps.We relied upon Medicaid enrollment data for 1208 children (mean age = 19 months) enrolled in the Carolina Oral Health Literacy project during 2008-09. The median follow-up was 25 months. Health literacy was measured using the Newest Vital Sign (NVS). Analyses relied on descriptive, bivariate, and multivariate methods based on Poisson modeling.One-third of children experienced one or more enrollment gaps; most were short in duration (median = 5 months). The risk of gaps was inversely associated with caregivers' age, with a 2% relative risk decrease for each added year. Low health literacy was associated with a modestly elevated risk increase [Incidence Rate Ratio (IRR) = 1.17 (95% confidence interval (CI) 0.88-1.57)] for enrollment disruptions; however, this estimate was substantially elevated among caregivers with less than a high school education [IRR = 1.52 (95% CI 0.99-2.35); homogeneity p<0.2].Our findings provide initial support for a possible role of caregivers' health literacy as a determinant of children's Medicaid enrollment gaps. Although the association between health literacy and enrollment gaps was not confirmed statistically, we found that it was markedly stronger among caregivers with low educational attainment. This population, as well as young caregivers, may be the most vulnerable to the negative effects of low health literacy. |
url |
http://europepmc.org/articles/PMC4193870?pdf=render |
work_keys_str_mv |
AT jessicaylee caregivershealthliteracyandgapsinchildrensmedicaidenrollmentfindingsfromthecarolinaoralhealthliteracystudy AT kimondivaris caregivershealthliteracyandgapsinchildrensmedicaidenrollmentfindingsfromthecarolinaoralhealthliteracystudy AT darrenadewalt caregivershealthliteracyandgapsinchildrensmedicaidenrollmentfindingsfromthecarolinaoralhealthliteracystudy AT adianebaker caregivershealthliteracyandgapsinchildrensmedicaidenrollmentfindingsfromthecarolinaoralhealthliteracystudy AT ziyagizlice caregivershealthliteracyandgapsinchildrensmedicaidenrollmentfindingsfromthecarolinaoralhealthliteracystudy AT rgaryrozier caregivershealthliteracyandgapsinchildrensmedicaidenrollmentfindingsfromthecarolinaoralhealthliteracystudy AT williamfvann caregivershealthliteracyandgapsinchildrensmedicaidenrollmentfindingsfromthecarolinaoralhealthliteracystudy |
_version_ |
1724935046110904320 |