Abstract 16038: Health Literacy Predicts Cardiovascular Risk in the Male Prison Population

Abstract

Background: Cardiovascular disease (CVD) is the leading cause of death in inmates in the United States. CVD risk reduction is essential in this population. Limited health literacy may reduce one’s ability to learn, analyze and apply health related information. Given the lower education level of inmates, it is likely that their health literacy levels are low. It is unknown whether health literacy is associated with risk for CVD in this population.

Objective: The purpose of this study was to determine whether health literacy levels independently predict cardiovascular risk in the male prison population.

Methods: Male inmates, in 4 Kentucky prisons completed a health literacy assessment, using the Newest Vital Sign (NVS), with lower scores indicating limited health literacy levels. Individuals were categorized into adequate and limited health literacy groups based upon the NVS scoring algorithm with the cut-point of 3. The Framingham Risk Score (FRS), a measure of the 10 year risk for CVD was used to assess cardiovascular risk. Multiple linear regression analysis was used to examine whether health literacy was an independent predictor of 10 year risk of CVD while controlling for body mass index, marital status, ethnicity, health perception, and education level.

Results: Of the 358 inmates (mean age = 36 yrs., 36.9% non-white, 86% single, mean educational level = 12.3 yrs.), 27% were categorized in the limited health literacy group. Mean scores of the FRS were 6.1 ± 4.7, consistent with the CVD risk profile of males in the same age range within the general U.S. population. Compared to participants with limited health literacy, participants with adequate health literacy were less likely to have increased 10-year CVD risk (Standardized β= -.106; p-value = .036).

Conclusion: This was the first study to indicate that limited health literacy independently predicts 10-year CVD risk in male inmates. These findings suggest that interventions to improve health literacy might have a substantial impact on CVD risk in this population.