Sujay Kakarmath1, Vanessa Denis2, Marta Encinas-Martin2, Francesca Borgonovi2, S V Subramanian3. 1. Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA. 2. Department for Education and Skills, Organisation for Economic Co-operation and Development, 2 Rue André Pascal, 75116, Paris, France. 3. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA. svsubram@hsph.harvard.edu.
Abstract
OBJECTIVES: To assess the relationship between general literacy proficiency and self-rated poor health by analyzing data from the Programme for the International Assessment of Adult Competencies, an international survey conducted from 2011 to 2015 in 33 high- and upper middle-income countries and national sub-regions. METHODS: Logistic regression was used to model general literacy proficiency as a predictor of self-rated poor health. RESULTS: Data from 167,062 adults aged 25-65 years were analyzed. The mean overall prevalence of self-rated poor health was 24%. The odds ratio of self-rated poor health for those in the lowest level of general literacy proficiency compared to those in the highest level was 2.5 (95% CI 2.2-3.0) in the unadjusted model, and 1.9 (95% CI 1.6-2.2) in the adjusted model. This association was robust over time and across countries. General literacy proficiency attenuated 22% of the effect of self-education on self-rated poor health, in addition to a substantial independent effect of its own. CONCLUSIONS: Our study provides robust and generalizable evidence that general literacy proficiency is independently associated with self-rated poor health. These results offer a potential modifiable target for policy interventions to reduce educational inequities in health.
OBJECTIVES: To assess the relationship between general literacy proficiency and self-rated poor health by analyzing data from the Programme for the International Assessment of Adult Competencies, an international survey conducted from 2011 to 2015 in 33 high- and upper middle-income countries and national sub-regions. METHODS: Logistic regression was used to model general literacy proficiency as a predictor of self-rated poor health. RESULTS: Data from 167,062 adults aged 25-65 years were analyzed. The mean overall prevalence of self-rated poor health was 24%. The odds ratio of self-rated poor health for those in the lowest level of general literacy proficiency compared to those in the highest level was 2.5 (95% CI 2.2-3.0) in the unadjusted model, and 1.9 (95% CI 1.6-2.2) in the adjusted model. This association was robust over time and across countries. General literacy proficiency attenuated 22% of the effect of self-education on self-rated poor health, in addition to a substantial independent effect of its own. CONCLUSIONS: Our study provides robust and generalizable evidence that general literacy proficiency is independently associated with self-rated poor health. These results offer a potential modifiable target for policy interventions to reduce educational inequities in health.
Keywords:
Educational attainment; Literacy; OECD; Programme for the International Assessment of Adult Competencies; Self-rated poor health; Socioeconomic status
Authors: Darren A Dewalt; Nancy D Berkman; Stacey Sheridan; Kathleen N Lohr; Michael P Pignone Journal: J Gen Intern Med Date: 2004-12 Impact factor: 5.128
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