Health Literacy and Perceived Control: Intermediary Factors in the Relationship Between Race and Cardiovascular Disease Risk in Incarcerated Men in the United States.

The analysis used baseline data from a longitudinal study, so it cannot show that health literacy or perceived control caused CVD risk or that changing them would reduce risk. Participants were only men in four Kentucky medium security prisons, and women were not enrolled because of administrative regulations. The sample was young, with mean age 36 years, and relatively healthy because of the parent intervention design. Twenty-nine of 378 baseline participants were excluded for missing data, and six people who did not report race or identified as neither White nor Black were excluded from race analysis. Participants were self-selected, and the authors could not determine whether those who participated differed in health literacy or CVD risk from those who did not. Answers may have been affected by incarceration, because participants could fear prison administrators. The Framingham Risk Score did not include social determinants of health, and adverse childhood experiences were not collected.

The supplied article text does not include a conflict of interest statement. The supplied metadata lists non-U.S. government and NIH extramural research support.

Do not conclude that race caused higher CVD risk or that improving health literacy and perceived control will lower it. The total and direct race effects were not significant, and the analysis used baseline data, so it shows associations, not tested treatment effects.