Associations Between Low Literacy and Health Status Measures: Cross-Sectional Analyses of Two Physical Activity Trials

Abstract

Arthritis researchers have thoroughly documented a powerful relationship between years of education and health outcomes, but they have not documented the role of literacy. The authors examined the associations between literacy and arthritis health status measures. Participants were recruited from southeastern urban and rural areas. Rapid Estimate of Adult Literacy in Medicine, which provides an estimate of reading level in less than 3 minutes, was administered to 447 participants at baseline in 2 community-based randomized controlled trials of lifestyle interventions designed for aging sedentary adults with arthritis. Those who read below ninth grade were considered to have low literacy. Among the 447 study participants, the median sample age was 69 years. A majority of the participants were women (86%), Caucasian (80%), overweight or obese (72%). Of all participants, 20% had low literacy. Significantly more African Americans (54%) than Caucasians (12%) had low literacy levels (p < .001). Individuals with low literacy did not have significantly worse disability or arthritis symptoms than individuals with adequate literacy (all ps > .05). Among our study participants, 1 in 5 had low literacy, but literacy was not associated with health status in this population.

Acknowledgments

People With Arthritis Can Exercise (PACE) was supported by the Centers for Disease Control and Prevention through a grant from the Association of American Medical Colleges (grant number MM-0275-03/03). Active Living Every Day (ALED) was supported by a grant from the Centers for Disease Control and Prevention and the American Association of Medical Colleges (grant number MM-0644-04).

Notes

Note. PACE = People with Arthritis Can Exercise; ALED = Active Living Every Day.

¹Results with the continuous variable, before the variable was dichotomized, were not different from the results presented in our Results section.

Note. HAQ = Health Assessment Questionnaire; REALM = Rapid Estimate of Adult Literacy in Medicine; VAS = Visual Analogue Score.

Note. Values reported are n (%).

Note. B stands for unstandardized regression coefficients; SE for the standard error of B, and β for standardized regression coefficients. HAQ = Health Assessment Questionnaire; VAS = Visual Analogue Score.

*p < .05; **p < .01.

Presented as a poster, “The Association between Low Literacy and Health Status Measures Among Older Adults With Arthritis,” at the Annual Scientific Meeting of American College of Rheumatology, October 24–29, 2008, San Francisco, CA. Abstract was published in the Scientific Meetings Supplement.