Association between low health literacy and adverse health behaviors in North Carolina, 2016

Authors

Manan Roy, Appalachian State UniversityFollow
Adam Hege, Appalachian State UniversityFollow
Erin D. Bouldin, Appalachian State UniversityFollow

Corresponding Author

Name: Manan Roy

Email: roym1@appstate.edu

Author Affiliations

1. Manan Roy, Ph.D.

Department of Nutrition and Health Care Management,

Beaver College of Health Sciences, Appalachian State University,

1179 State Farm Road, Boone, North Carolina 28607, USA

Email: roym1@appstate.edu

2. Adam Hege, Ph.D., MPA

Department of Health and Exercise Science,

Beaver College of Health Sciences, Appalachian State University,

1179 State Farm Road, Boone, North Carolina 28607, USA

Email: hegeba@appstate.edu

3. Erin Bouldin, Ph.D., MPH

Department of Health and Exercise Science,

Beaver College of Health Sciences, Appalachian State University,

1179 State Farm Road, Boone, North Carolina 28607, USA

Email: bouldinel@appstate.edu

Author Area of Expertise

1. Manan Roy: health economics, econometrics

2. Adam Hege: Public Health

3. Erin Bouldin: Public Health and Epidemiology

Abstract

Introduction: Health literacy (HL) is an urgent public health challenge facing the U.S. HL is a critical factor in health inequities and exacerbates underlying social determinants of health.

Purpose: This study assesses the association between low HL (LHL) and adverse health behaviors, which contribute to poor health.

Methods: Researchers used North Carolina’s 2016 Behavioral Risk Factor Surveillance System data, namely, the Health Literacy optional module which asks respondents to rate how difficult it is for them to get health-related advice or to understand medical information (verbal or written). Health behaviors analyzed were excessive alcohol consumption, lack of adequate exercise and sleep, and irregular medical and dental check-ups. The sample was divided into four age categories (18–49, 50–64, and 65–75, and 76 and older) for statistical comparisons. Stata 15 and a user-written Stata command, -psacalc-, were used to examine the relationships by addressing omitted variable bias in OLS regressions.

Results: Findings indicate that LHL has a direct robust relationship with not exercising, inadequate sleep, irregular health and dental checkup, and health screenings across different age groups. Among women, LHL is associated with getting a Pap test in 3 years as opposed to more than 3 years.

Implications: The adverse behaviors can explain the mechanisms underlying the link between LHL and adverse health outcomes. Further research on the causal relationship between LHL and adverse health behaviors using longitudinal data on a broader geographic region is warranted.

DOI

https://doi.org/10.13023/jah.0403.02

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 License.

Recommended Citation

Roy M, Hege A, Bouldin ED. Association between low health literacy and adverse health behaviors in North Carolina, 2016. J Appalach Health 2022;4(3):23–38. DOI: https://doi.org/10.13023/jah.0403.02.