Assessment of health literacy across types of hyperparathyroidism

Health literacy is the ability to obtain, process, and understand basic health information necessary to make informed decisions. Low health literacy has been associated with delays in diagnosis and treatment, reduced adherence, and worse clinical outcomes. This study aimed to assess health literacy among individuals with hyperparathyroidism.

The National Institutes of Health All of Us Research database was used to evaluate health literacy in adults with primary, renal secondary, nonrenal secondary, and tertiary hyperparathyroidism. Health literacy was assessed using 3 questions from the Overall Health survey adapted from the Brief Health Literacy Screening Tool (BRIEF-3). Scores ranged from 3 to 15, with >9 indicating adequate health literacy and ≤9 indicating inadequate health literacy. Chi-square tests compared health literacy across hyperparathyroidism subtypes and demographic variables, with P < .05 considered significant.

Among 6,473 participants, 85.7% demonstrated adequate health literacy and 14.3% had inadequate health literacy. Females were more likely to have adequate health literacy than males (88.1% vs 81.8%, P < .001). Inadequate health literacy was more prevalent among Black participants compared with White participants (16.7% vs 6.4%, P < .001). Employment, higher education, and higher income were strongly associated with adequate health literacy (all P < .001). Inadequate health literacy was most common in renal secondary hyperparathyroidism (18.0%), followed by tertiary (12.4%), nonrenal secondary (9.5%), and primary hyperparathyroidism (8.3%) (P < .001).

Inadequate health literacy is more prevalent among socioeconomically disadvantaged patients and those with renal secondary hyperparathyroidism. These disparities highlight the need for targeted educational interventions and tailored communication strategies to improve care in vulnerable populations.