Limited literacy in older people and disparities in health and healthcare access.
OBJECTIVE
To determine the relationship between health literacy, demographics, and access to health care.


METHODS
Cross-sectional study, Health, Aging and Body Composition data (1999/2000).


METHODS
Memphis, Tennessee, and Pittsburgh, Pennsylvania.


METHODS
Two thousand five hundred twelve black and white community-dwelling older people who were well functioning at baseline (without functional difficulties or dementia).


METHODS
Participants' health literacy was assessed using the Rapid Estimate of Adult Literacy in Medicine. Scores were categorized into 0 to sixth-, seventh- to eighth-, and ninth-grade and higher reading levels (limited health literacy defined as <9th grade). Participants' demographics, socioeconomic status, comorbidities, and three indicators of healthcare access (whether they had a doctor/regular place of medical care, an influenza vaccination within the year, or insurance for medications) were also assessed.


RESULTS
Participants' mean age was 75.6, 52% were female, 38% were black, and 24% had limited health literacy. After adjusting for sociodemographics, associations remained between limited health literacy and being male, being black, and having low income and education, diabetes mellitus, depressive symptoms, and fair/poor self-rated health (P<.02). After adjusting for sociodemographics, health status, and comorbidities, older people with a sixth-grade reading level or lower were twice as likely to have any of the three indicators of poor healthcare access (odds ratio=1.96, 95% confidence interval=1.34-2.88).


CONCLUSIONS
Limited health literacy was prevalent and was associated with low socioeconomic status, comorbidities, and poor access to health care, suggesting that it may be an independent risk factor for health disparities in older people.
Sudore
Rebecca L
RL
Department of Medicine, Division of Geriatrics, University of California-San Francisco, San Francisco, CA, USA. rsucsf@yahoo.com
Mehta
Kala M
KM
Simonsick
Eleanor M
EM
Harris
Tamara B
TB
Newman
Anne B
AB
Satterfield
Suzanne
S
Rosano
Caterina
C
Rooks
Ronica N
RN
Rubin
Susan M
SM
Ayonayon
Hilsa N
HN
Yaffe
Kristine
K
D000368:Aged; D000369:Aged, 80 and over; D044383:Black People; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003710:Demography; D004522:Educational Status; D005260:Female; D006297:Health Services Accessibility; D006304:Health Status; D006801:Humans; D007182:Income; D008297:Male; D044465:White People