Health literacy and health risk behaviors among older adults

Background: Limited health literacy is associated with poorer physical and mental health, although the causal pathways are not entirely clear. In this study, the association between health literacy and the prevalence of health risk behaviors was examined among older adults. Methods: A cross-sectional survey of 2923 new Medicare, managed-care enrollees was conducted in four U.S. metropolitan areas (Cleveland OH; Houston TX; Tampa FL; Fort Lauderdale-Miami FL). Health literacy was measured using the short form of the Test of Functional Health Literacy in Adults. Behaviors investigated included self-reported cigarette smoking, alcohol consumption, physical activity, body mass index, and seat belt use. Results: Individuals with inadequate health literacy were more likely to have never smoked (46.7% vs. 38.6, p = 0.01); to completely abstain from alcohol (75.6% vs. 57.9, p < 0.001); and to report a sedentary lifestyle (38.2% vs. 21.6%, p < 0.001) compared to those with adequate health literacy. No significant differences were noted by mean body mass index or seat belt use. In multinomial logistic regression models that adjusted for relevant covariates, inadequate health literacy was not found to be significantly associated with any of the health risk behaviors investigated. Conclusions: Among community-dwelling elderly, limited health literacy was not independently associated with health risk behaviors after controlling for relevant covariates.