Examining health literacy disparities in the United States: a third look at the National Assessment of Adult Literacy (NAAL)

BMC Public Health

Research Article

Alison Beauchamp¹  R. V. Rikard²  Maxine S. Thompson³  Julie McKinney⁴ 

[1] Deakin Population Health SRC, Faculty of Health, Deakin University, Melbourne, VIC, Australia;Department of Media & Information, Michigan State University, 409 Comm Arts, 404 Wilson Road, 48824, East Lansing, MI, USA;Department of Sociology & Anthropology, North Carolina State University, Raleigh, NC, USA;McKinney Health Literacy Services, Cambridge, MA, USA;

关键词: Educational Attainment;    Health Literacy;    Item Response Theory;    Civic Engagement;    Social Resource;   

DOI  :  10.1186/s12889-016-3621-9

 received in 2016-03-10, accepted in 2016-09-02,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundIn the United States, disparities in health literacy parallel disparities in health outcomes. Our research contributes to how diverse indicators of social inequalities (i.e., objective social class, relational social class, and social resources) contribute to understanding disparities in health literacy.MethodsWe analyze data on respondents 18 years of age and older (N = 14,592) from the 2003 National Assessment of Adult Literacy (NAAL) restricted access data set. A series of weighted Ordinary Least Squares (OLS) regression models estimate the association between respondent’s demographic characteristics, socioeconomic status (SES), relational social class, social resources and an Item Response Theory (IRT) based health literacy measure.ResultsOur findings are consistent with previous research on the social and SES determinants of health literacy. However, our findings reveal the importance of relational social status for understanding health literacy disparities in the United States. Objective indicators of social status are persistent and robust indicators of health literacy. Measures of relational social status such as civic engagement (i.e., voting, volunteering, and library use) are associated with higher health literacy levels net of objective resources. Social resources including speaking English and marital status are associated with higher health literacy levels.ConclusionsRelational indicators of social class are related to health literacy independent of objective social class indicators. Civic literacy (e.g., voting and volunteering) are predictors of health literacy and offer opportunities for health intervention. Our findings support the notion that health literacy is a social construct and suggest the need to develop a theoretically driven conceptual definition of health literacy that includes a civic literacy component.

【 授权许可】

CC BY   
© The Author(s). 2016