title: Does Context Matter? Literacy Disparities in Self-rated Health Using Evidence from 17 Developed Countries.
abstract: OBJECTIVE
  The study examines whether adult literacy skills predict self-rated health status beyond educational credentials in 17 developed countries using a cross-national survey, the Programme for the International Assessment of Adult Competencies (PIAAC).
  
  
  METHODS
  The study uses linear regression models with country-level fixed effects to predict self-rated health to account the unobserved country-level heterogeneity. A total of 73,806 respondents aged 25 to 65 were included in the analysis.
  
  
  RESULTS
  Although adult literacy is positively associated with better self-rated health in general, the strength of the relationship varies across nations. The literacy-related health inequalities are less severe in countries with the higher public share of health expenditures that may better address the needs of individuals with limited cognitive abilities. Curriculum standardization also contributes to reducing the literacy gradients in health by decreasing variations in skills obtained in school across individuals with different social origins.
  
  
  CONCLUSIONS
  Overall, this study reveals that promoting equity in adult literacy skills is an important way to improve a population's health. Country-level differences in the strength of the relationship between literacy and self-rated health are systematically related to between-country differences in health financing and educational systems.
authors.affiliation: Yeonjin Lee, Asia Research Institute, National University of Singapore, Singapore;, Email: arileey@nus.edu.sg.
authors.forename: Yeonjin
authors.initials: Y
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D019049:Developed Countries; D005260:Female; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D000067010:Literacy; D008297:Male; D008875:Middle Aged; D011634:Public Health / Q000191:economics; D057566:Self Report