Health Literacy and Health Risk Behaviors Among Older Adults

Institute for Healthcare Studies, Northwestern University, Chicago, Illinois 60611, USA.
American Journal of Preventive Medicine (Impact Factor: 4.53). 01/2007; 32(1):19-24. DOI: 10.1016/j.amepre.2006.08.024
Source: PubMed


Limited health literacy is associated with poorer physical and mental health, although the causal pathways are not entirely clear. In this study, the association between health literacy and the prevalence of health risk behaviors was examined among older adults.
A cross-sectional survey of 2923 new Medicare, managed-care enrollees was conducted in four U.S. metropolitan areas (Cleveland OH; Houston TX; Tampa FL; Fort Lauderdale-Miami FL). Health literacy was measured using the short form of the Test of Functional Health Literacy in Adults. Behaviors investigated included self-reported cigarette smoking, alcohol consumption, physical activity, body mass index, and seat belt use.
Individuals with inadequate health literacy were more likely to have never smoked (46.7% vs. 38.6, p =0.01); to completely abstain from alcohol (75.6% vs. 57.9, p <0.001); and to report a sedentary lifestyle (38.2% vs. 21.6%, p <0.001) compared to those with adequate health literacy. No significant differences were noted by mean body mass index or seat belt use. In multinomial logistic regression models that adjusted for relevant covariates, inadequate health literacy was not found to be significantly associated with any of the health risk behaviors investigated.
Among community-dwelling elderly, limited health literacy was not independently associated with health risk behaviors after controlling for relevant covariates.

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    • "The World Health Organization proposes a holistic approach to school health programs in the form of the health-promoting schools concept, and this approach to school health promotion has been adopted around the world (Keshavarz et al. 2010). Health literacy is closely related with health behaviors, illness prevention or treatment, chronic disease management, health disparities, and health outcomes (Horowitz and Kleinman 2008; von Wagner et al. 2007; Wolf, Gazmararian, and Baker 2007). Oral health education in schools also has an important and crucial role in promoting students' oral health (Chapman, Copestake, and Duncan 2006; Kwan et al. 2005; Petersen 2008). "
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    ABSTRACT: There is a discrepancy in knowledge and comprehension about oral health between dental professionals and students. Therefore, for dental professionals to give health education, it is essential that they fully understand students' oral health literacy level. The purpose of this research was to determine the usefulness of a mouth drawing as a visual oral health literacy instrument by comparing changes in health literacy before and after oral health education. Mouth drawing by students, as the visual oral health literacy instrument, was conducted before (first drawing) and after (second drawing) oral health education in 2010 to 162 Japanese senior high school students. Tooth and gingiva scores were calculated based on the criteria and changes in the scores before and after oral health education were analyzed. Tooth scores were significantly higher than gingiva scores in both male and female students. Comparison of scores before and after health education showed that both tooth and gingiva scores significantly increased after health education. A student's self-evaluation comparing his/her own first and second drawings showed that 72.8% of all students answered the ‘second drawing’ was better, and 27.2% answered the ‘first drawing’ or ‘the same’. A visual oral health literacy instrument makes possible evaluation of students' oral health literacy both visually and quantitatively. A proper health education program, based on the subjects' oral health literacy level, should effectively improve oral health behavior and oral health status.
    International Journal of Health Promotion and Education 11/2013; Volume 52(1):38 - 46. DOI:10.1080/14635240.2013.845412
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    • "HL may directly influence one's health, for instance, due to misunderstanding/misuse of medications [9]. At the same time, HL may influence health through various wellknown health determinants including healthcare service use, health and disease management behaviors (e.g., smoking), economic resource access, and living environments [10] [11] [12] [13] [14]. Additionally, previous studies found that social factors such as access to quality education early in life and continuous opportunities for continuous literacy improvement (e.g., work-related literacy tasks) and health literacy proficiency are interrelated [15] [16]. "
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    ABSTRACT: Background. Health literacy, the set of skills for locating, understanding, and using health-related information, is associated with various health outcomes through health behaviors and health care service use. While health literacy has great potential for addressing health disparities stemming from the differing educational attainment in diverse populations, knowledge about subpopulations that share the same risk factors is useful. Objective. This study employed a logistic regression tree algorithm to identify subpopulations at risk of limited health literacy in Canadian adults. Design. The nationally representative data were derived from the International Adult Literacy and Skills Survey (n = 20,059). The logistic regression tree algorithm splits the samples into subgroups and fits logistic regressions. Results. Results showed that the subpopulation comprised of individuals 56 years and older, with household income less than $50,000, no participation in adult education programs, and lack of reading activities (i.e., newspaper, books) was at the greatest risk (82%) of limited health literacy. Other identified subgroups were displayed in an easily interpreted tree diagram. Conclusions. Identified subpopulations organized in tree diagrams according to the risk of limited health literacy inform not only intervention programs targeting unique subpopulations but also future health literacy research.
    04/2013; 2013. DOI:10.1155/2013/130263
    • "In the Baker and colleagues’ study, inadequate health literacy had been reported as 24/5% for older adults.[18] Wolf and colleagues estimated health literacy to be 22/2% in the elderly.[20] Orlu and colleagues in a systematic study on 85 papers reported that 26% of individuals had inadequate and 20% of them had marginal health literacy.[31] "
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    ABSTRACT: Health literacy is a measure of an individual's ability to read, comprehend, and act on medical instructions. Limited health literacy can reduce the adults' ability to comprehend and use basic health-related materials, such as prescription, food labels, health education pamphlets, articles, appointment slips, and health insurance plans, which can affect their ability to take appropriate and timely health care action. Nowadays, low health literacy is considered a worldwide health threat. So, the purpose of this study was to assess health literacy level in older adults and to investigate the relationships between health literacy and health status, health care utilization, and health preventive behaviors. A cross-sectional survey of 354 older adults was conducted in Isfahan. The method of sampling was clustering. Health literacy was measured using the Test of Functional Health Literacy in Adults (TOFHLA). Data were collected using home interviewing. Health status was measured based on self-rated general health. Health care utilization was measured based on self-reported outpatient clinic visits, emergency room visits, and hospitalizations, and health preventive behaviors were measured based on self-reported preventive health services use. Approximately 79.6% of adults were found to have inadequate health literacy. They tended to be older, had fewer years of schooling, lower household income, and were females. Inadequate health literacy was associated with poorer general health (P < 0.001). Health literacy level was negatively associated with outpatient visits (P = 0.003) and hospitalization (P = 0.01). No significant association was found between health literacy level and emergency room utilization. Self-reported lack of PSA (Prostate-Specific Antigen) test (P < 0.001) and fecal occult blood test (FOBT; P = 0.003) was higher among individuals with inadequate health literacy than those with adequate health literacy. No significant association was found between health literacy level and mammogram in the last 2 years. Low health literacy is more prevalent in older adults. It indicates the importance of health literacy issue in health promotion. So, with simple educational materials and effective interventions for low health literacy group, we can improve health promotion in the society and mitigate the adverse health effects of low health literacy.
    08/2012; 1(1):31. DOI:10.4103/2277-9531.100160
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