Numeracy Skills, Health Information-Seeking, and Preventative Health Behaviors among Middle and Older Aged Adults in the U.S.

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Yamashita, T., Bardo, A.R., Liu, D. (2018). Numeracy Skills, Health Information-Seeking, and Preventative Health Behaviors among Middle and Older Aged Adults in the U.S. Retrieved 9/12/2018, from Washington, DC.


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Background: Given the information/technology rich environment coupled with ongoing trends in population aging in the U.S., the central role that health literacy plays in determining health behaviors and outcomes has recently received an increasing amount of attention. Despite a growing research and policy focus on health literacy, some key components that constitute this multifaceted construct that reflects one’s ability to access, process, and understand basic health information remain under-examined. Specifically, print and oral literacy have been extensively examined, but the potentially important role that numerical literacy (i.e., numeracy) plays in shaping health behaviors remains largely unknown. This issue is particularly pertinent for the older population, which is generally characterized by worsening overall physical and cognitive health. Therefore, we examined the role of numeracy in the context of relevant health determinants, including health information seeking and preventive health behaviors. Methods: Data were obtained from the 2012/2014 Program for the International Assessment of Adult Competencies (PIAAC), which include a nationally representative sample of American adults ages 45-74 years old. Detailed descriptive statistics and appropriate regression analyses were conducted with the use of a SAS macro program developed by the International Association for the Evaluation of Educational Achievement (IEA). Multivariate associations between numeracy skills and eight health information sources (newspaper, magazines, internet, radio, television, books, friends and family, health professional) and four preventive health behaviors (flu shot, dental check-up, vision screening, osteoporosis screening) were estimated after adjusting for age, gender, race, educational attainment, employment status, self-rated health, literacy skills, and use of numeracy skills at home. The PIAAC final sampling weights and replicate weights were also used to generate nationally representative and unbiased findings. Results: We provided detailed descriptive statistics for numeracy skills by demographic (i.e. age, gender, race) socioeconomic (i.e., education, and employment status) and health (i.e., self-rated health) characteristics, as well as by health information sources (i.e., health professionals, internet, television, friends and family, books, newspapers, magazines, and radio), and preventive health behaviors (i.e., flu shot, dental checkup, vision screening, and osteoporosis screening). Multivariate results, conditioned on these demographic, socioeconomic and health characteristics, and other controls, indicated that the medium to high numeracy proficiency was associated with less frequent use of magazines, books, television, and newspapers as health information sources with respect to the low numeracy proficiency. Furthermore, numeracy skillswere positively associated with dental checkups, but they were not associated with other preventive health practices, after accounting for the sociodemographic, health and other covariates. Significance: The present study is among the first to provide a nationally representative overview and exploration of numeracy skills data among middle-aged and older adults in the U.S. Thus, results from the current study represent a foundation from which future research can build upon, which ideally will lead to the identification of specific pathways that link numeracy skills with health behaviors and outcomes. Findings highlight social and economic disparities in numeracy proficiency, and the potentially important role that numeracy skills play in determining health information seeking and preventive health behaviors. These findings are useful for informing policy discussions aimed at population health promotion. Specifically, it may be beneficial for future health education and communication to target specific health information sources and improve accessibility to the vulnerable populations who generally have lower numeracy skills.