It is possible that increasing general knowledge of health insurance, a key prerequisite to “entry” into healthcare, may serve to increase a patient’s confidence and self-efficacy to enroll in relevant programs enabled by healthcare reform and to navigate the healthcare system. In this manner, HIL can be seen as a type of education that functions similarly to other recognized pathways linking the social determinants of education, health literacy and health. Further research is needed to elucidate these possible mediating mechanisms between HIL and enrollment in healthcare programs.

This work was supported by the College of Health Sciences and Human Services (now the College of Health Professions) at the University of Texas Rio Grande Valley (previously The University of Texas-Pan American). The College played no role in study design; in the collection, analysis and interpretation of data; in the writing of the manuscript; and in the decision to submit the manuscript for publication.

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