Towards understanding the links between health literacy and physical health.

Abstract

Objective: Low health literacy predicts poor health, but the underpinnings of the associations are yet to be understood. This study tested the associations between health literacy and three objective health outcomes in older people and investigated the extent to which general (not health-related) cognition and earlier life-course factors such as childhood cognitive ability, educational level and occupational class accounted for these associations. Methods: Participants were 730 community-dwelling older people (350 women; mean age 72.50 years, SD = 0.71). Physical fitness (defined by walk time, lung function, and grip strength), body mass index, and count of natural teeth were used as health outcomes. Rapid Estimate of Adult Literacy in Medicine (REALM), Shortened Test of Functional HealthLiteracy in Adults (S-TOFHLA), and Newest Vital Sign (NVS) were used to measure health literacy.Age-11 and concurrent general cognitive ability, educational level, and occupational social class were used as co-variates. Results: Lower REALM, S-TOFHLA and NVS scores were associated with worse scores on all health outcomes (β = .09 to .17). However, cognitive ability in old age and childhood, educational and occupational levels accounted for the majority of these associations: after adjusting for these co-variates, only physical fitness was significantly associated with REALM and S-TOFHLA (β = .06 and .11). Conclusions: Low health literacy was associated with poorer health largely because it reflected general cognitive ability, educational and/or occupational levels. These variables plays some role in health beyond their association with the reading and numeracy skills captured by common health literacy measures.

Cognitive Function and Health Literacy Decline in a Cohort of Aging English Adults

“…Our finding that cognitive function mostly explained the relationship between older age and health literacy decline was expected, based on cross-sectional evidence showing that the constructs of cognition and health literacy overlap to a large degree 12,13,18,26. Contrary to our findings, the association between age and health literacy was independent of cognitive impairment according to the Mini Mental Status Examination (MMSE) score in previous research,14,16,17 although the MMSE does not detect subtle individual differences in cognitive function.…”

Could autonomous motivation hold the key to successfully implementing lifestyle changes in affective disorders? A multicentre cross sectional study

“…A possible explanation for the difference in motivation could be situated in the environment of the lower educated patients. For example, lower educated people have lower perceived competence to produce desired outcomes such as initiating and maintaining physical activity behaviour (Droomers et al, 2001), possibly because they may have lower levels of health literacy and therefore their capacity to interpret and use healthcare information is less than those with higher levels of education (Mõttus et al, 2014). Similarly, lower educated patients mostly have restricted access to resources and physical activity facilities, thereby missing opportunities to be physically active (Vancampfort et al, 2013c).…”

Does general intelligence moderate the association between inflammation and psychological distress?

“…Intelligence is a problem-solving capacity which has been shown to assist individuals in coping with their adverse situations and related stressors (Masten et al, 1999). Additionally, individuals with higher intelligence may better educate themselves about how to manage their health, both physical and mental, which means they are more likely to engage in behaviours that prevent ill health (or help with disease management), such as exercising more, eating more healthily, avoiding tobacco use and taking medication and treatments as prescribed (Deary et al, 2010;Mõttus et al, 2014;Murray, Johnson, Wolf, & Deary, 2011). Keeping healthy and managing one's physical health problems may help to stave off psychological distress.…”