TABLE 2.
Multivariate Logistic Regression Results Showing Influence of Maternal Health Literacy on TANF and Food Stamp Program Participation at Birth and 6 Months: The Health Insurance Improvement Project, June 2005–August 2006
| TANF |
Food Stamps |
|||||||
| Baseline (n = 626) |
6 Months (n = 499) |
Baseline (n = 590) |
6 Months (n = 472) |
|||||
| OR (95% CI) | P | OR (95% CI) | P | OR (95% CI) | P | OR (95% CI) | P | |
| Maternal health literacy | ||||||||
| Inadequate | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| Marginal | 2.41 (1.04, 5.61) | .04 | 2.61 (0.96, 7.11) | .06 | 2.13 (0.89, 5.08) | .09 | 1.59 (0.60, 4.23) | .35 |
| Adequate | 2.18 (1.09, 4.35) | .03 | 3.04 (1.35, 6.84) | .008 | 1.95 (0.97, 3.92) | .06 | 1.72 (0.78, 3.77) | .18 |
| Maternal age, y | ||||||||
| ≤ 20 | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| 21–24 | 1.36 (0.80, 2.33) | .26 | 4.22 (2.11, 8.44) | < .001 | 1.63 (0.94, 2.83) | .08 | 1.37 (0.74, 2.54) | .31 |
| 25–29 | 1.10 (0.55, 2.21) | .80 | 3.13 (1.29, 7.62) | .01 | 2.13 (1.00, 4.55) | .05 | 0.92 (0.38, 2.23) | .86 |
| 30–34 | 0.59 (0.25, 1.40) | .23 | 2.49 (0.79, 7.85) | .12 | 0.86 (0.35, 2.11) | .74 | 0.50 (0.17, 1.48) | .21 |
| ≥ 35 | 0.08 (0.02, 0.41) | .003 | 1.57 (0.36, 6.79) | .55 | 0.37 (0.12, 1.15) | .09 | 0.24 (0.06, 0.93) | .04 |
| Income, $ | ||||||||
| < 250/mo | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| 251–500/mo | 1.43 (0.86, 2.37) | .16 | 1.04 (0.55, 2.00) | .9 | 1.18 (0.68, 2.03) | .56 | 2.76 (1.35, 5.65) | .005 |
| 501–999/mo | 0.62 (0.36, 1.07) | .09 | 0.29 (0.14, 0.59) | .001 | 0.79 (0.43, 1.42) | .42 | 1.32 (0.66, 2.66) | .44 |
| 1000–1499/mo | 0.17 (0.08, 0.36) | < .001 | 0.11 (0.04, 0.27) | < .001 | 0.31 (0.15, 0.64) | .001 | 0.68 (0.28, 1.62) | .38 |
| > 1500/mo | 0.20 (0.10, 0.41) | < .001 | 0.07 (0.03, 0.17) | < .001 | 0.28 (0.14, 0.57) | .001 | 0.49 (0.22, 1.11) | .09 |
| No. of children | ||||||||
| 1 | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| 2 | 1.65 (1.02, 2.67) | .04 | 1.33 (0.74, 2.38) | .34 | 2.10 (1.29, 3.41) | .003 | 2.90 (1.61, 5.19) | < .001 |
| ≥ 3 | 3.05 (1.78, 5.22) | < .001 | 2.62 (1.36, 5.04) | .004 | 5.53 (3.07, 9.96) | < .001 | 9.37 (4.44, 19.77) | < .001 |
| Education | ||||||||
| Less than high school | 1.00 | 1.00 | 1.00 | 1.00 | ||||
| High school | 0.81 (0.49, 1.34) | .41 | 0.67 (0.35, 1.29) | .23 | 0.72 (0.43, 1.23) | .23 | 1.00 (0.52, 1.92) | .99 |
| High school or greater | 0.80 (0.49, 1.29) | .36 | 0.42 (0.22, 0.77) | .006 | 0.89 (0.53, 1.50) | .66 | 0.74 (0.39, 1.39) | .35 |
| Race | ||||||||
| Black | … | … | 1.00 | … | … | 1.00 | … | |
| Other | … | … | 0.44 (0.23, 0.84) | .01 | 0.62 (0.38, 1.02) | .06 | 0.53 (0.29, 0.99) | .05 |
| Employment | ||||||||
| Student | … | … | 1.00 | … | … | … | … | |
| Full time | … | … | 1.49 (0.78, 2.84) | .23 | … | … | … | … |
| Unemployed, looking for work | … | … | 0.66 (0.27, 1.59) | .35 | … | … | … | … |
| Unemployed, not looking for work | … | … | 2.39 (0.96, 5.92) | .06 | … | … | … | … |
| Missing | … | … | 0.60 (0.30, 1.21) | .15 | … | … | … | … |
| Baseline housing situation | ||||||||
| Living alone | … | … | … | … | 1.00 | 1.00 | ||
| Living with friends or relatives | … | … | … | … | 0.71 (0.46, 1.10) | .12 | 0.68 (0.39, 1.17) | .16 |
Note. OR = odds ratio; CI = confidence interval; TANF = Temporary Assistance for Needy Families. Multivariate logistic regression was performed to obtain the best estimate of the relation between maternal health literacy and participation with a best subsets approach to arrive at final models separately for birth and 6 months of age. Analytic samples for TANF participation were 626 (of 744) at birth and 499 (of 744) at 6 months; for Food Stamp Program participation, samples were 590 (of 744) at birth and 472 (of 744) at 6 months. No significant differences were found in the distribution of demographic variables (infant birth weight, maternal age, maternal birth country, maternal education, maternal employment) between the analytic samples and the full cohort (data not shown). ORs present estimates for all predictors included in each of the 4 best models. Associations between explanatory variables were assessed to exclude multicollinearity. Although health literacy was related to maternal education, 38% of the mothers with inadequate health literacy had an education greater than high school. Although income and employment were significantly related (P < .001), they were not collinear, and both contributed to the model. All analyses were conducted with SAS (Version 9.1.3; SAS Institute Inc, Cary, NC).