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Health Literacy and 1-Year Mortality in CVD

Mayo Clin Proc; ePub 2018 Nov 7; Mayberry, et al

In adults hospitalized for cardiovascular disease (CVD), patient-level factors linked low health literacy (HL) and 1-year mortality, according to a recent study. A total of 3,000 adults treated from October 11, 2011, through December 18, 2015 for acute coronary syndrome (ACS) or acute decompressed heart failure (ADHF) participated in the Vanderbilt Inpatient Cohort Study. Participants completed a bedside-administered survey and consented to health record review and longitudinal follow-up. Multivariable mediation models examined the direct and indirect effects of HL with 1-year mortality after discharge. Researchers found:

  • Of 2,977 patients discharged from the hospital (60% male, mean age 61 years, 83% non-Hispanic white, 37% admitted for ADHF), 17‒23% had inadequate HL depending on the measure, and 10% died within 1 year.
  • Lower HL on 1-year mortality was decomposed into an indirect effect (adjusted odds ratio [aOR]=1.50) via the mediators and a nonsignificant direct effect (aOR=0.87).
  • Each SD decrease in HL was associated with an absolute 3.2 percentage point increase in the probability of 1-year mortality via mediators admitted for ADHF, comorbidities, health behavior and competence, and previous-year hospitalizations.


Mayberry LS, Schildcrout JS, Wallston KA, et al. Healthy literacy and 1-year mortality: Mechanisms of association in adults hospitalized for cardiovascular disease. [Published online ahead of print November 7, 2018]. Mayo Clin Proc. doi:10.1016/j.mayocp.2018.07.024.