Does Literacy Predict Self Rated Health and Chronic Illness in Mid Life 4.12.10

Does Literacy Predict Self-Rated Health and Chronic Illness in Mid-Life? Ian M. Bennett MD PhD,* Laryssa Mykyta,** School of Medicine* and Department of Sociology**, University of Pennsylvania, Philadelphia, PA References Table 1. Weighted Sample Characteristics Data and Methods National Longitudinal Survey of Youth (NLSY)-1979 Respondents who completed a Health Module at age 40 or above (n=7,808) Dependent variables : 1 ) Self Rated Health ; 2) chronic conditions (ever diagnosed with hypertension, diabetes, or heart disorder); and 3) the SF-12 Physical Component Score. Primary Independent Variables : 1) Literacy; Reading Grade Level (RGL) calculated from the ASVAB VE composite score, 2) Educational Attainment at age 35. Analysis : Logistic & OLS regression models Support Results Introduction Conclusions/Discussion 1 Figure 1. Participant Selection Table 2. Odds Ratios from Regressions Predicting Fair/Poor Self Rated Health (Fair/Poor coded 1, all others coded 0) A All models control for age of respondent when the health module was administered. B Model 3 includes controls for gender, race/ethnicity, nativity, marital status, poverty status at age 14-21, and proportion of years in poverty between ages 25, maternal educational attainment, and marital history. * p<0.05; ** p<0.01; *** p<0.001 Table 3. Odds Ratios from Regressions Predicting Chronic Illness Table 4. Weighted Coefficients from OLS Models Predicting SF-12 PCS (higher value signifies better health) This paper contributes to the literature on literacy and health across the life course. Literacy is associated with a range of poor health-related outcomes, including mortality among older adults in the United States. However, evidence that literacy contributes to poor health in earlier stages of the life course is limited and is based on cross-sectional studies which limit the ability to disentangle literacy from other social determinants of health. ,[object Object],[object Object],[object Object],[object Object],[object Object],Dr. Bennett is supported by a career development grant from the National Institute of Child Health and Human Development (NICHD; 1K23HD048915-01A2 ). Contact: [email_address] Baker, D. W., Wolf, M. S., Feinglass, J., Thompson, J. A., Gazmararian, J. A., & Huang, J. (2007). Health literacy and mortality among elderly persons. Archives ofInternal Medicine, 167 , 1503-1509. Bennett, I. M., Chen, J., Soroui, J. S., & White, S. (2009). The Contribution of Health Literacy to Disparities in Self-Rated Health Status and Preventive Health Behaviors in Older Adults. Annals of Family Medicine, 7 , 204-211. Berkman ND, DeWalt DA, Pignone MP, Sheridan SL, Lohr KN, Lux L, Sutton SF, Swinson T, & AJ, B. (2004). Literacy and Health Outcomes . Rockville, MD: Agency for Healthcare Research and Quality. Kutner M, Greenberg E, & J, B. (2005). A First Look at the Literacy of America ’ s Adults in the 21st Century : National Center for Educational Statistics. NLSY79 Users Guide . (2004). Columbus OH: Center for Human Resource Research, Ohio State University Ware, J. E., Jr., & Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical Care, 30 , 473- 483. Waters, B., Barnes, J., Foley, P., Steinhaus, S., & Brown, D. (1988). Estimating the Reading Skills of Military Applicants: Development of an ASVAB toRGLConversion Table . Alexandria,VA: Human Resources Research Organization. *Significant difference in Gender (P<0.001) Purpose Investigate whether literacy assessed at ages 16-24 is independently associated with poor/fair self-reported health status, chronic conditions, and the SF12 Physical Component Score (PCS) at midlife. Outcome Variables Percent or Mean (SD) Self-Rated Health * Excellent 23.1 Very Good 39.9 Good 26.4 Fair 8.4 Poor 2.1 Chronic Illness 20.3 SF-12 PCS* 52.4(7.8) Explanatory Variables Literacy: Reading Grade Level * <5 th grade 9.3 5 th - 6 th grade 8.9 7 th -8 th grade 12.4 9 th – 11 th grade 37.6 12 th grade and higher 31.8 Educational Attainment age 35* Less than high school 8.4 High school graduate/GED 43.0 Some College 22.0 College Graduate 24.6 Missing 2.0 Socio-Demographic Variables Age at Health Assessment 41.1 (1.0) Gender Female 51.8 Male 48.2 Race White 70.5 Black 14.5 Hispanic 5.5 Other 9.5 Non US Born 4.1 Marital History at Health Assessment* Never Married 11.5 Married 62.4 Divorced/Separated/Widowed 16.4 Missing 9.7 In Poverty age 14-21 12.5 Missing 6.2 Prop Years Poverty 25-40* 0.12 (0.24) NLSY ‘79 N = 12,686 N = 9,763 Removed From Analysis Dropped From Study (White low income and Military) N = 2,923 Missing ASVAB N=579 N =9,184 Missing Health Module 40 N=1,285 N =7,899 N = 7,884 Final Sample N =7,808 (80% of Eligible) Missing Health Module 40 N=1,285 Missing SRH, SF12, Chron Dis N=64 Explanatory Variable Omitted Category in Parentheses Model 1 A Bivariate Model 2 A, Adjusted for literacy and education Model 3 A,B With Demographic & SES Controls Literacy: Grade Level ( >= 12 th grade ) <5 th grade 5.87*** 2.60*** 1.76** 5 th - 6 th grade 3.57*** 1.78*** 1.36 7 th - 8 th grade 1.65** 0.93 0.78 9 th -11 th grade 1.47** 1.02 0.97 Educational Attainment by age 35 ( Diploma/GED ) Less than high school 2.36*** 1.71*** 1.44** Some College 0.51*** 0.59*** 0.62*** College Degree or More 0.21*** 0.26*** 0.32*** Explanatory Variable Omitted Category in Parentheses Model 1 A Bivariate Model 2 A Adjusted for literacy and education Model 3 A,B With Demographic & SES Controls Literacy: Grade Level ( >= 12 th grade ) <5 th grade 1.73*** 1.43** 1.04 5 th - 6 th grade 1.38** 1.16 0.94 7 th - 8 th grade 1.14 0.98 0.87 9 th -11 th grade 1.08 0.98 0.94 Educational Attainment by age 35 (Diploma/GED ) Less than high school 1.17 1.03 0.99 Some College 0.87 0.92 0.93 College Degree or More 0.67*** 0.71** 0.76* Explanatory Variable Omitted Category in Parentheses Model 1 A Bivariate Model 2 A Adjusted for literacy and education Model 3 A,B With Demographic & SES Controls Literacy: Grade Level ( >= 12 th ) <5 th grade -3.93*** -1.92*** -0.81 5 th - 6 th grade -2.77*** -1.13** -0.47 7 th - 8 th grade -0.93** 0.31 0.68 9 th -11 th grade -0.76** -0.01 0.04 Educational Attainment by age 35 ( High School Diploma/GED ) Less than high school -2.67*** -2.02*** -1.40** Some College 1.05*** 0.81** 0.64* College Degree or More 2.67*** 2.35*** 1.84***

Does Literacy Predict Self Rated Health and Chronic Illness in Mid Life 4.12.10

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Does Literacy Predict Self Rated Health and Chronic Illness in Mid Life 4.12.10