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Published online by Cambridge University Press: 21 December 2023
Although health problems are often a natural consequence of aging, many older adults struggle to manage their health care problems. Health literacy refers to the ability to access, process, and use health information to make appropriate decisions to promote good overall health. Low levels of health literacy are associated with a host of negative outcomes such as less efficient use of healthcare services, higher healthcare costs, increased mortality, and poorer self-rated health. In those with medical conditions (e.g., diabetes), lower health literacy is linked with higher levels of depression. It is important to investigate whether mental health is linked to health literacy as understanding these links has the potential to identify those at risk for negative outcomes and thus implement protective strategies. Therefore, the current study sought to determine the extent to which various mental health constructs such as happiness, well-being, anxiety and depression are related to health literacy in a community-based sample of cognitively healthy individuals. We hypothesized that higher levels of health literacy would be associated with higher self-reported well-being, happiness, and lower anxiety and depression.
Design - Cross-sectional, prospective study. Setting - Community-based. 93 individuals were included with mean age=59.02 years (SD=15.12) and mean education=15.70 (SD=2.39). 60% were women, the majority were White (55%) while 38% were Black and 7% belonged to other races; 90% were non-Hispanic.
Health Literacy - Health literacy was measured by an 8-item instrument in the Rush Memory and Aging Project that examined the participant’s understanding of health care, treatment, and related behaviors. Happiness - Happiness was measured by 5 items from the Satisfaction with Life Scale using a 7-point scale (1 = strongly agree; 7 = strongly disagree). Higher scores indicated lower levels of happiness. Well-being - Well-being was measured with an 18-item instrument from the Rush Memory and Aging project, with higher scores indicating better well-being. Statistics: Bivariate correlations between age, education, and mental health measures and health literacy were examined.
Higher level of health literacy was significantly associated with age (r = .282 p = .009) and education (r = .228 p = .039). Contrary to our hypothesis, health literacy was not significantly associated with happiness (r = .002 p = .987), well-being (r = .037 p = .742), depression (r = .005 p = .962) or anxiety (r = -.064 p = .568). Even after controlling for age and education, these associations remained significant.
Higher level of healthy literacy was associated with older age and higher level of education. However, no significant association was found between health literacy and mental health measures of happiness, well-being, depression, and anxiety in cognitively healthy individuals, even after controlling for demographics. The lack of such associations in this study was unexpected and suggests that other factors such as the presence of health conditions (e.g., diabetes, cancer) might critically contribute to such associations. Future studies should examine these associations in a larger context to better understand how to promote healthy self-care behaviors.
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