Health literacy as a predictor of emergency department visits and self-rated health among Chinese immigrants: findings from an Australian survey

Objectives: Our objectives were to examine health literacy among first-generation Chinese immigrants living in Australia, identifying health literacy domains associated with emergency department (ED) visits and self-rated health (SRH). Methods: Chinese immigrants (n = 362, mean age = 59) were recruited from communities across New South Wales and surveyed for health literacy, ED visits in the past 12 months, and SRH using the Health Literacy Questionnaire (simplified Chinese version). Results: More than 70% of participants experienced health literacy difficulties. Health literacy was significantly lower among the following participants: older, migration at older age, recent immigrants, and those without university level education or proficient English. ED visits were independently associated with the health literacy domains lacking 'social support for health' (OR: 1.80; p =.031) and 'ability to appraise health information' (OR: 2.22; p =.005). Poor SRH was associated with the health literacy domains 'insufficient health information' (OR: 1.81; p = .025), 'inactively managing health' (OR: 1.72; p =.048), and 'lacking ability to appraise health information' (OR: 1.70; p =.048). Conclusions: Inadequate health literacy was identified in the majority of first-generation Chinese immigrants and it had significantly association with higher prevalence of ED use and poorer SRH. Practice implications: Early screening and support for health literacy is critical in Chinese immigrants. (c) 2020 Elsevier B.V. All rights reserved.