Caregivers’ Health Literacy and Gaps in Children’s Medicaid Enrollment: Findings from the Carolina Oral Health Literacy Study

Jessica Y Lee, Kimon Divaris, Darren A DeWalt, A Diane Baker, Ziya Gizlice, R Gary Rozier and William F Vann

PLOS ONE, 2014, vol. 9, issue 10, 1-11

Abstract: Background and Objectives: 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. Methods: 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. Findings: 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

Date: 2014
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0110178

DOI: 10.1371/journal.pone.0110178

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