Rafael Ruiz, MS, Department of Health Policy and Administration, University of North Carolina, School of Public Health, University of North Carolina, Chapel Hill, NC 27599-7411, 919 960-8402, rruiz@email.unc.edu, Deborah E. Bender, PhD, MPH, Department of Health Policy and Administration, The University of North Carolina at Chapel Hill, School of Public Health, Chapel Hill, NC 27599-7400, and Daniel Lee, PhD, Cecil G. Sheps Center for Health Services Research, University of North Carolina Chapel Hill, 101 Conner Dr. Ste.302, Willowcrest Bldg., CB#3386, Chapel Hill, NC 27599.

Latinos are the fastest growing ethnic group in the United States. During the past decade, the Latino population in North Carolina has increased by 394%. It is estimated that 65% of these immigrants arrived from Mexico, but large proportions have also journeyed to the US from Honduras, Guatemala and Colombia. Health care providers, who are largely unprepared for the rapid increase in Latino patient visits, often identify immigrants by national origin.

Research suggests that Latino patients from rural areas of two countries may have more in common with one another than patients from the same country. This finding is potentially useful for improving communication between health providers and their Spanish-speaking patients.

This paper presents findings demonstrating an important relationship between a respondent’s origin (rural vs. pueblo vs. urban), education, and health literacy [measured by the Test of Functional Health Literacy in Adults (TOFHLA)]. Pearson chi-squares show a significant correlation between completion of 6th grade or less and rural origin and between origin and health literacy (p=<.001). Also, OLS regression finds that education and rural origin are associated with health literacy (p=<.05).

These preliminary analyses suggest that asking Spanish-speaking patients several indirect questions about location of birthplace and place of early schooling may provide better information about education level than a direct question. In populations known to be sensitive to providing socially appropriate responses and when time to administer the TOFHLA is limited, these indirect questions may improve the presentation of health information, communication, and quality of care.

Learning Objectives:

• To describe the relationship between rural origin, educational level and health literacy
• To recommend strategies to improve the quality of communication between health care providers and Latino immigrant patients

Keywords: Health Literacy, Communication

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.