health Literacy; hypertension; low-salt diet; self-management; black Americans; primary care


Community Health and Preventive Medicine | Public Health | Translational Medical Research


This study examines the association between health literacy and adherence to low-salt diet practices among individuals with hypertension. Health literacy is the ability of individuals to understand and utilize health information. We surveyed 238 patients with hypertension from a primary care clinic in Charlotte, NC. We assessed health literacy and self-reported low-salt diet. Logistic regression was used to model the relationship between health literacy and low-salt diet adherence. Respondents were primarily female (67.3%) and black (80%). Black Americans were less likely to have adequate health literacy as compared to white Americans (21.8% vs. 55.8%). The study found no association between adequate health literacy and adherence to a low-salt diet (OR = 1.06, 95% CI: 0.36-3.10) after adjusting for confounders. This study addresses the conflicting findings for health literacy in two related areas: chronic illness self-care, and nutrition/diet skills. Additional research is warranted among black Americans given their increased risk of hypertension, low rates of diet adherence and previous findings of positive associations between health literacy and nutrition skills.