The Role of Health Literacy in Reducing Negative Perceptions of Breast Health and Treatment Among Uninsured Primary Care Patients.

Breast cancer is the second leading cause of cancer death among women in the United States. There are disparities in breast cancer mortality by race/ethnicity and socio-economic factors. Health literacy may have an impact on breast health disparities. In addition, learning about people's perceptions of breast health and treatment is important to understand why some do not seek a mammogram or treatment for breast cancer. The purpose of this study is to examine the association between health literacy and negative perceptions of breast health and treatment among female uninsured primary care patients utilizing a free clinic for underserved populations. Women utilizing a free clinic who were aged 40 years or older (N = 276) participated in a self-administered survey from September to December in 2015. Higher levels of health literacy were associated with lower levels of negative perceptions of breast cancer and treatment. Non-US born English speakers reported higher levels of negative perceptions of breast cancer and treatment than US born English speakers and Spanish speakers. While there were no significant differences in health literacy among the groups, US born English speakers were less likely to have had a mammogram in the past 3 years compared with non-US born English speakers and Spanish speakers. Future research should consider where women are obtaining information and how the method of exposure shapes their attitudes towards breast health and in turn, their rates of examinations for breast cancer. Cultural factors may be also important determinants of the perceptions and need to be further examined.