This project examines the impact of health literacy on health and detects areas/individuals at risk of limited health literacy, which is known to be associated with a variety of health outcomes. Health literacy includes reading and writing skills but also sets of abilities necessary to make informed health decisions throughout one’s life. This project includes three empirical studies.
The first study uses data (the Adult Literacy and Life Skills Survey) from Canada, the U.S., Switzerland, Italy, Norway and Bermuda to examine the associations between literacy skills, education and health outcomes. The results show diverse impacts of health literacy skills across countries. In addition, the literacy skills have fair impacts on the established relationship between education and health. In light of a heath literacy theoretical framework, individuals’ self-learning about health beyond formal education may be key to improve and maintain health over the life course.
The second study employs geographic information system (GIS) to detect areas with high prevalence of limited health literacy and provide visualized map-format data to inform future policy planning and intervention program in the U.S. The county-level data are obtained from the National Assessment of Adult Literacy. Results show that a large numbers of individuals with limited health literacy are concentrated in major populous cities. Additionally, clusters of neighboring counties with high prevalence of limited health literacy are identified near the U.S. – Mexico border, and south-eastern parts of the U.S.
The third study analyzes the only publically available nationally representative data of health literacy using a novel statistical technique, logistic regression tree-based method to identify sub-groups of individuals in Canada. The sub-group of individuals with older age, lower income, less frequent reading activities and less participation in recent adult education programs was at the highest risk of limited health literacy.
Finally, the findings from these three empirical studies are summarized to demonstrate contributions to the literature and practice. In view of health literacy theoretical framework, this project also addresses practical implications for existing public health disparity issues, and promotes learning about health over the life course. Accordingly, specific suggestions for future research and practice are discussed.