Health Insurance Literacy and Health Disparities in the United States: A Literature Review

Abstract

This paper presents a literature review of health insurance literacy with a focus on specialized populations in the U.S. and how limited health literacy skills exacerbate health disparities. This discussion places this issue within the context of contemporary U.S. health care reform and makes connections between health insurance coverage and health disparities. This overview of the research on health insurance literacy covers research across the health insurance spectrum, from awareness of health insurance options to assessments of health literacy skills in specific populations as well as from readability of health insurance informational materials to the availability of multilingual services. In exploring the demographic variables associated with lower health insurance literacy skills, this paper reviews the body of current research in this area to make connections between populations more likely to have unequal access to health care and how having limited skills in navigating the U.S. health care system may compound these disparities. In addition, this paper proposes an Integrated Framework for Health Insurance Literacy as a method for further studying the connections between demographic factors, health coverage, health status, and health insurance literacy skills.

“I think sometimes the whole process is just a little bit intimidating”: modeling the health insurance decision-making process

“…The additional questions in the semi-structured interview guide were developed using sensitizing concepts from the integrated framework for health insurance literacy (Vardell, 2019) and the concepts represented in the models discussed in the Literature review section of this paper. The interview guide was piloted with participants recruited at the university's benefits orientation sessions for new employees and was refined using the pilot data.…”

Data-driven approaches to bridging the gap in health communication disparities: A systematic review

“…The scope of health communication disparities extends beyond individual-level factors to include systemic and structural barriers that perpetuate inequalities in healthcare access and outcomes (Logan et al, 2015). Socio-economic factors such as income, education level, and employment status play a significant role in determining access to healthcare resources and information (Vardell, 2019;Ikechukwu et al, 2019). Language proficiency is a critical determinant of health communication, as individuals who are not proficient in the dominant language of their healthcare system may face challenges in understanding medical instructions, communicating with healthcare providers, and accessing culturally appropriate health information (Yin et al, 2009;Coker et al, 2023).…”

Per aspera ad astra: The big challenge of consumers' insurance literacy

“…In the former strand of literature, Lin et al. (2019) demonstrate that a more specialized education can increase insurance literacy, which is shown to vary with socio‐demographic characteristics for both life and non‐life products (Tennyson, 2011), including private health policies (Bartholomae et al., 2016; Christy et al., 2017; O'Connor & Kabadayi, 2020; Vardell, 2019). All this evidence cited refers to the U.S. insurance market, except for that of Lin et al.…”