Health Literacy and Physical Function Among Older Black and Hispanic Individuals With Heart Failure

Insufficient health literacy negatively impacts outcomes for heart failure (HF). Older adults with HF face significant barriers, including prevalence of multiple comorbidities, frailty and deficits in physical function, which can impact HF outcomes. Examination of the association between health literacy and physical function remains limited in older adults with HF. We investigated the cross-sectional associations of health literacy and physical function in a cohort of older self-identified Black and Hispanic patients with HF.

The Screening for Cardiac Amyloidosis with Nuclear Imaging in Minority Populations (SCAN-MP) study recruited participants (age ≥ 60 years) of self-identified Black race or Hispanic ethnicity in New York City, Boston and New Haven. We measured health literacy by using the Newest Vital Sign, and we measured physical function by using the 6-minute walk duration (6MWD) and the Short Physical Performance Battery test (SPPB). Linear regression models evaluated the association between participants' health-literacy levels and physical function, as defined by continuous measures of 6MWD and SPPB. Only 12.7% of the cohort (n = 433) had adequate health literacy. After adjusting for age, sex, number of comorbidities, and neighborhood social vulnerability, those with adequate (compared to limited) health literacy demonstrated better performance on the 6MWD (β = 37.5 m, 95% CI [1.49, 73.5]; P = 0.04) and SPPB (β = 1.18 (0.41, 1.95); P = 0.002).

Older Black or Hispanic participants with HF have an extremely high prevalence of limited health literacy, which is associated with poor physical function. Interventions targeting health literacy may represent an avenue to improve HF outcomes for patients with minoritized backgrounds.