• Juliana Ferri-Guerra, Y Nadeem Mohammed, Raquel Aparicio-Ugarriza, Douglas Salguero, Aakashi Shah, Dhanya Baskaran, Marianne Desir, and Jorge G Ruiz.
• Geriatric Research, Education and Clinical Center, Bruce W. Carter Miami VA Medical Center, 1201 NW 16th St, Miami, FL 33125. Email: j.ruiz@miami.edu.
• Am J Manag Care. 2020 May 1; 26 (5): 200-206.

ObjectivesTo determine whether health literacy, numeracy, and graph literacy are associated with all-cause hospitalizations or mortality in community-dwelling veterans.Study DesignRetrospective cohort study.MethodsA total of 470 community-dwelling veterans underwent evaluations of health literacy, numeracy, and graph literacy with validated instruments in 2012 and were followed until 2018. At the end of follow-up, the associations with all-cause hospitalizations and mortality were determined with the Andersen-Gill model and Cox regression multivariate analysis, respectively.ResultsThere were no associations of health literacy, numeracy, or graph literacy with all-cause hospitalization or mortality after multivariate adjustment. In subgroup analysis, subjective numeracy was associated with hospitalizations in African Americans. Higher objective and subjective numeracy were associated with future hospitalizations only for those with a history of hospitalization. Higher graph literacy was associated with lower mortality in those with a history of hospitalization.ConclusionsThis study did not show associations of health literacy, numeracy, or graph literacy scores with lower risk of all-cause hospitalization or mortality. Further research is needed with random sampling in a broader spectrum of healthcare settings to better understand what roles health literacy, numeracy, and graph literacy might play in healthcare utilization and clinical outcomes.

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