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

Rikard, R.V., Thompson, Maxine S., McKinney, Julie and Beauchamp, Alison 2016, Examining health literacy disparities in the United States: a third look at the National Assessment of Adult Literacy (NAAL), BMC public health, vol. 16, Article Number : 975, pp. 1-11, doi: 10.1186/s12889-016-3621-9.

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Title Examining health literacy disparities in the United States: a third look at the National Assessment of Adult Literacy (NAAL)
Author(s) Rikard, R.V.
Thompson, Maxine S.
McKinney, Julie
Beauchamp, AlisonORCID iD for Beauchamp, Alison orcid.org/0000-0001-6555-6200
Journal name BMC public health
Volume number 16
Season Article Number : 975
Start page 1
End page 11
Total pages 11
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2016-09-13
ISSN 1471-2458
Keyword(s) Science & Technology
Life Sciences & Biomedicine
Public, Environmental & Occupational Health
SELF-RATED HEALTH
SOCIOECONOMIC-STATUS
PUBLIC-HEALTH
RACIAL-DIFFERENCES
REPORTED HEALTH
SOCIAL-CLASS
CARE
MORTALITY
INFORMATION
MEN
Summary BACKGROUND: In 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.

METHODS: We 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.

RESULTS: Our 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.

CONCLUSIONS: Relational 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.
Language eng
DOI 10.1186/s12889-016-3621-9
Field of Research 111706 Epidemiology
1117 Public Health And Health Services
Socio Economic Objective 920408 Health Status (e.g. Indicators of Well-Being)
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2016, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30086667

Document type: Journal Article
Collections: Population Health
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.