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. METHODSWe 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. RESULTSOf 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 (infl uenza 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 infl uenza 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.

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The frequency of listener responses, called backchannels, was studied in English conversations within and across two cultural groups: Americans from the midwestern United States and Japanese who were born and raised in Japan. The findings reveal that backchannels of several types are displayed far more frequently by Japanese listeners. This appears to be related to the greater use by Japanese of certain discourse constructions that favor backchannels, and to the Japanese culture. The Japanese listening style remains unchanged in cross-cultural conversations, but Americans alter listening style in the direction of their non-native interlocutors. The study found no evidence for the hypothesis that backchanneling conventions that are not shared contribute to negative personality attributions or stereotyping. (Conversational analysis, intercultural communication, Japanese and American English discourse)

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This article presents data on the types and duration of reading-related activities reported by a volunteer sample of 400 adults (demographically similar to the U.S. adult population age 20 and older in terms of race, ethnicity, education, and working status) in the 2005 Real-World Tasks Study. This diary study revealed that adults spent, on average, 4.5 hours a day on activities that involve reading printed and electronic texts, a relatively higher percentage of which occurred on working than on nonworking days. Prose and quantitative tasks were more common (98 and 94 minutes, respectively) than hybrid and document tasks (40 and 25 minutes, respectively). Hybrid tasks constituted 15% of the total daily reading-related literacy time, a novel finding because hybrid tasks have not been Dr. Barbara Forsyth worked at Westat, Maryland, when this study was conducted. This article is intended to promote the exchange of ideas among researchers and policymakers. The views expressed in it are part of ongoing research and analysis and do not reflect the position of the Department of Education or its affiliated institutions.

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