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The Contribution of Health Literacy to Disparities in Self-Rated Health Status and Preventive Health Behaviors in Older Adults

Bibliographic Data

ID23355261
AuthorsIan M Bennett (0000-0002-7139-9456, University of Pennsylvania Health System), Jingxu Chen (0000-0003-2395-6120, American Institutes for Research), J S Soroui, Jaleh Soroui (American Institutes for Research), S WHITE (0000-0002-4261-054X), Simon D M White (0000-0002-1061-6154, United States Department of Education)
Year2009
Volume7
Issue3
Pages204-211
Publication date2009-05-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueThe Annals of Family Medicine (JOURNAL)
Journal identifiersISSN: 1544-1709 • E-ISSN: 1544-1717
PublisherAnnals of Family Medicine (PUBLISHER)
DOI10.1370/afm.940
PMID19433837
PMCIDPMC2682976
OpenAlexW2128816921
LanguageEN
Citations received79
References cited14

PURPOSE: Health literacy is associated with a range of poor health-related outcomes. Evidence that health literacy contributes to disparities in health is minimal and based on brief screening instruments that have limited ability to assess health literacy. The purpose of this study was to assess whether health literacy contributes, through mediation, to racial/ethnic and education-related disparities in self-rated health status and preventive health behaviors among older adults. METHODS: We undertook a cross-sectional study of a nationally representative sample of 2,668 US adults aged 65 years and older from the 2003 National Assessment of Adult Literacy. Multiple regression analysis was used to assess for evidence of mediation. RESULTS: Of older adults in the United States, 29% reported fair or poor health status, and 27% to 39% reported not utilizing 3 recommended preventive health care services in the year preceding the assessment (influenza vaccination 27%, mammography 34%, dental checkup 39%). Health literacy and the 4 health outcomes (self-rated health status and utilization of the 3 preventive health care services) varied by race/ethnicity and educational attainment. Regression analyses indicated that, after controlling for potential confounders, health literacy significantly mediated both racial/ethnic and education-related disparities in self-rated health status and receipt of influenza vaccination, but only education-related disparities in receipt of mammography and dental care. CONCLUSIONS: Health literacy contributes to disparities associated with race/ethnicity and educational attainment in self-rated health and some preventive health behaviors among older adults. Interventions addressing low health literacy may reduce these disparities.

Educational attainment · Ethnic group · Health care · Health education · Health equity · Health literacy · Health promotion · Mediation · Public health · Race and health · Self-rated health · Data-Driven Disease Surveillance · Global Cancer Incidence and Screening · Health Literacy and Information Accessibility · Medicine · Nursing · Gerontology

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