Health Literacy Is Associated With Health Behaviors and Social Factors Among Older Adults: Results from the LifeLines Cohort Study

Figures & data

Table 1. Prevalence of health behaviors and social factors of the participants by level of health literacy.

	Health literacy
	Low (n = 1081, 33.4%)	High (n = 2160, 66.6%)	Total (n = 3241)	P
Health behaviors
Insufficient physical activity	33.5	27.6	29.5	<.001
Insufficient fruit consumption	35.5	29.2	31.3	.003
Insufficient vegetable consumption	68.8	60.6	63.4	<.001
Smoker	6.3	5.7	5.9	.50
No regular breakfast consumption	6.1	4.0	4.7	.007
High alcohol consumption	30.8	34.6	33.3	.033
Obesity	19.4	15.0	16.4	.001
Social factors
Lonely	12.7	7.5	9.2	<.001
Low social support	5.0	4.2	4.5	.27
Few social activities	10.8	7.6	8.7	.004
Few social contacts	12.9	9.1	10.3	<.001
Living alone	17.1	17.0	17.1	.96

Note. All p-values are based on χ² tests.

Table 2. Associations between health literacy (low vs. high) and health behaviors, crude and adjusted for gender and baseline age.

	Low (vs. high) health literacy
	Crude OR (95% CI)	p	Adjusted OR (95% CI)	p
Insufficient (vs. sufficient) physical activity (n = 3121)	1.32 (1.13–1.55)	<.001	1.31 (1.11–1.54)	<.001
Insufficient (vs. sufficient) fruit consumption (n = 2152)	1.34 (1.11–1.62)	.003	1.41 (1.16–1.70)	<.001
Insufficient (vs. sufficient) vegetable consumption (n = 2145)	1.43 (1.19–1.73)	<.001	1.51 (1.24–1.83)	<.001
Smoker (vs. no smoker) (n = 3146)	1.11 (0.82–1.52)	.50	1.19 (0.87–1.63)	.26
Lack of regular (vs. regular) breakfast consumption (n = 3222)	1.57 (1.13–2.18)	.008	1.66 (1.19–2.32)	.003
High (vs. low) alcohol consumption (n = 3180)	0.84 (0.72–0.99)	.033	0.81 (0.69–0.96)	.013
Obesity (vs. non-obesity) (n = 3241)	1.37 (1.13–1.66)	.001	1.35 (1.11–1.63)	.002

Note. Bold ORs indicate that p < .05. OR = Odds ratio, CI = Confidence interval.

Table 3. Associations between health literacy (low vs. high) and social factors, crude and adjusted for gender and baseline age.

	Low (vs. high) health literacy
	Crude OR (95% CI)	p	Adjusted OR (95% CI)	p
Lonely (vs. not lonely) (n = 3194)	1.78 (1.39–2.26)	<.001	1.69 (1.32–2.16)	<.001
Low (vs. high) social support (n = 3189)	1.22 (0.86–1.72)	.27	1.15 (0.81–1.64)	.43
Few (vs. many) social activities (n = 2771)	1.48 (1.13–1.93)	.005	1.52 (1.16–2.00)	.002
Few (vs. many) social contacts (n = 3199)	1.48 (1.17–1.87)	.001	1.48 (1.17–1.87)	.001
Living alone (vs. living with others) (n = 3210)	1.01 (0.83–1.22)	.96	0.87 (0.71–1.07)	.18

Note. Bold ORs indicate that p < .05. OR = Odds ratio, CI = Confidence interval.

Table 4. Moderation of the associations between health literacy (low vs. high) and health behaviors by social factors, adjusted for gender and baseline age, in odds ratios (with 95% confidence intervals).

	Loneliness	Social support	Social activities	Social contacts	Living situation
Insufficient physical activity	1.06 (0.63–1.80)	0.68 (0.31–1.50)	0.87 (0.49–1.53)	1.35 (0.82–2.22)	1.50 (0.98–2.29)
Insufficient fruit consumption	0.66 (0.35–1.23)	1.87 (0.74–4.73)	0.77 (0.38–1.55)	1.09 (0.60–1.97)	0.83 (0.50–1.38)
Insufficient vegetable consumption	0.74 (0.39–1.38)	0.82 (0.33–2.03)	0.93 (0.45–1.92)	1.24 (0.67–2.29)	0.78 (0.47–1.31)
Smoking	0.73 (0.29–1.85)	0.62 (0.17–2.24)	0.60 (0.20–1.76)	0.25* (0.08–0.81)	0.89 (0.41–1.91)
Lack of regular breakfast consumption	1.02 (0.33–3.20)	0.81 (0.17–3.93)	0.91 (0.31–2.72)	0.36 (0.13–1.04)	1.80 (0.76–4.30)
High alcohol consumption	0.80 (0.47–1.34)	0.42 (0.18–1.01)	0.60 (0.31–1.14)	1.23 (0.74–2.06)	0.86 (0.56–1.30)
Obesity	1.15 (0.62–2.13)	0.84 (0.37–1.91)	0.91 (0.47–1.78)	0.76 (0.41–1.42)	0.98 (0.60–1.58)

Note. ORs indicating increase in risk of low health literacy due to unfavorable social factors. All analyses adjusted for age and gender.

*Bold indicates that p < .05.