Literacy Activity and Health among Older Adults in the USA

Health literacy skills are known to be a key mediator of the relationship between education and health in the general population. However, one aspect of health literacy skills--individuals' actual literacy activities--remains understudied, especially among older adults. Health disparities that are driven by inequalities in education and level of health literacy skills are particularly problematic for older adults since they are exacerbated in old age by disadvantages that accumulate over the life course. This study examined a nationally representative sample of US adults age 50 years and older (n = 2,573) using data from the 2014 Program for International Assessment of Adult Competencies (PIAAC). Parallel mediation analysis was conducted to examine the partial mediation effects of health literacy skills and literacy activity (i.e., reading at home) on the relationship between education and health. Results showed that both health literacy skills and literacy activity mediated the education--health relationship. On average, literacy skills mediated 31.89% and literacy activities mediated 9.59% of the effect of education of self-rated health. Literacy activity, such as reading, is an easily accessible, autonomous, and sustainable option for promoting health in later life. Policies that support the intersection of public health and education may promote lifelong learning and well-being among US adults.