Tetine Sentell|Wei Zhang|James W. Davis|Kathleen Kromer Baker|Kathryn L. Braun
The Influence of Community and Individual Health Literacy on Self-Reported Health Status
University of Hawai?i at M?noa|University of Hawai?i at M?noa|University of Hawai?i at M?noa|Hawaii Department of Health|Papa Ola Lokahi
individual health literacy established predictor individual health outcomes communitylevel health literacy may also impact individual health yet limited research simultaneously considered influence individual community health literacy individual healththe study goal determine community health literacy independent relationship individual selfreported health beyond individual health literacywe used data 2008 2010 hawaii health survey representative statewide telephone survey multilevel models predicted individual selfreported health individual community health literacy controlling relevant individuallevel education raceethnicity gender poverty insurance status age marital status communitylevel variables community poverty community educationthe sample included 11779 individuals within 37 communitiesindividual health literacy defined validated selfreported measurement communities defined zip code combinations community health literacy defined percentage individuals within community reporting low health literacy census data zip code tabulation areas provided communitylevel variablesin descriptive results 182 selfreported low health literacy 147 reported selfreported poor health communitylevel low health literacy ranged 537 3599 final multilevel models individual 200 95 ci 163244 community low health literacy 102 95 ci 100103 significantly positively associated selfreported poor health status percentage increase average low health literacy within community associated approximately 2 increase poor selfreported health individuals community also associated poorer health lower educational attainment older age poverty nonwhite raceboth individual community health literacy significant distinct correlates individual general health status primary care providers facilities consider address health literacy community individual levels