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.
CITATION STYLE
Kakarmath, S., Denis, V., Encinas-Martin, M., Borgonovi, F., & Subramanian, S. V. (2018). Association between literacy and self-rated poor health in 33 high- and upper middle-income countries. International Journal of Public Health, 63(2), 213–222. https://doi.org/10.1007/s00038-017-1037-7
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