Bridging the Gap

Health Education Needs Among Rural Populations with Chronic Illness and Low Health Literacy in Unincorporated Communities in Southern California

Bibliographic Data

ID15460610
AuthorsShiloh Williams (0000-0002-6235-3608, San Diego State University, Imperial Valley Campus, corresponding author), Ryan Shriver (San Diego State University), Ryan C Shriver (0009-0008-2581-5990, San Diego State University), Candace Juhala (San Diego State University), Candace C Juhala (San Diego State University)
Year2025
Volume23
Issue1
Pages21-21
Publication date2025-12-23
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueInternational Journal of Environmental Research and Public Health (JOURNAL)
Journal identifiersISSN: 1661-7827 • E-ISSN: 1660-4601
PublisherMultidisciplinary Digital Publishing Institute (PUBLISHER • CH)
DOI10.3390/ijerph23010021
PMID41595816
OpenAlexW7116930438
LanguageEN
References cited35

Rural and unincorporated communities (UCs) experience persistent health disparities driven by limited healthcare infrastructure, geographic isolation, and socioeconomic inequities. Health literacy (HL), the ability to obtain, understand, and use health information, is a critical yet underexplored determinant of health outcomes in these settings. This study examined HL and barriers to healthcare and health information access among low-income adults living with chronic conditions in nine rural UCs in Southern California. A descriptive cross-sectional survey was administered in English or Spanish to 222 respondents during community food distribution events. The questionnaire included demographics, self-reported health status, chronic disease history, perceived access to care and health information, trust in information sources and HL assessment using the Newest Vital Sign (NVS). Over four-fifths (82.7%) of respondents demonstrated limited or possibly limited HL. Although Spanish-speaking respondents scored significantly lower than English speakers on the NVS, language was not a significant predictor of HL after adjusting for age, gender, education and Hispanic origin. Lower education and older age were associated with reduced HL. One in four respondents reported barriers to healthcare access, primarily due to distance and appointment availability. Over half of the respondents reported difficulty accessing or understanding health information, regardless of HL or demographic characteristics. Doctors were the most trusted source of health information, while trust in government and religious organizations was lowest. Findings reveal pervasive low HL and broad challenges accessing care and health information across rural UCs, highlighting the structural and educational inequities underlying these disparities. Addressing these gaps requires community-driven, bilingual, and culturally resonant strategies that build trust, enhance communication, and strengthen health system accessibility for residents of unincorporated rural regions

Community health · Government (linguistics · Health care · Health education · Health equity · Health literacy · Literacy · Rural area · Rural health · Socioeconomic status · Diabetes Management and Education · Food Security and Health in Diverse Populations · Health Literacy and Information Accessibility

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