R. V. Rikard|Maxine Seaborn Thompson|Julie McKinney|Alison Beauchamp
Examining health literacy disparities in the United States: a third look at the National Assessment of Adult Literacy (NAAL)
Michigan State University|North Carolina State University|Carney Hospital|Deakin University
united states disparities health literacy parallel disparities health outcomes research contributes diverse indicators social inequalities ie objective social class relational social class social resources contribute understanding disparities health literacy analyze data respondents 18 years age older n 14592 2003 national assessment adult literacy naal restricted access data set series weighted ordinary least squares ols regression models estimate association respondents demographic characteristics socioeconomic status ses relational social class social resources item response theory irt based health literacy measure findings consistent previous research social ses determinants health literacy however findings reveal importance relational social status understanding health literacy disparities united states objective indicators social status persistent robust indicators health literacy measures relational social status civic engagement ie voting volunteering library use associated higher health literacy levels net objective resources social resources including speaking english marital status associated higher health literacy levels relational indicators social class related health literacy independent objective social class indicators civic literacy eg voting volunteering predictors health literacy offer opportunities health intervention findings support notion health literacy social construct suggest need develop theoretically driven conceptual definition health literacy includes civic literacy component