Health Literacy and Child Health Outcomes: From Prenatal to Birth and Infant Stages

The impact of parental health literacy and the health outcomes of young children is a poorly studied area. DeWalt et al., summarized the pertinent literature regarding literacy and child outcomes, not necessarily health literacy, from 1980 through 2008 [1]. They presented 24 studies that dealt with the relationship between literacy and child health outcomes and found that lower literacy was associated with a lack of basic knowledge regarding a known medical condition, difficulty utilizing consent forms, non-comprehension of the concepts behind prenatal screening, and nonunderstanding of educational brochures resulting in poorer health outcomes. However, the impact of health literacy on a baby occurs before birth or even before pregnancy [1]. Gossett and co-workers demonstrated that lower health literacy is associated with limited appreciation of the implications of aging on fertility and pregnancy, and the success rates of infertility treatments [2]. Low literacy and numeracy scores are also associated with poor knowledge about contraception and difficulty with use of contraceptives [3]. Individuals with low health literacy skills are less likely to use the Internet and more likely to have self-efficacy limitations [4]. Thus, a program such as Text4baby, which has “a free cell phone text messaging service for pregnant women and new moms” and provides “text messages [that] are sent three times a week with information on how to have a healthy pregnancy and a healthy baby” [5] succeeds best with individuals with higher health literacy levels [6, 7]. In studies of pregestational diabetics [8] and gestational diabetics [9], those with poor health literacy had significantly more unplanned pregnancies, had not discussed pregnancy planning with a physician, or had taken folic acid. Their literacy level had a significant