Health Literacy and Happiness: A Community-based Study
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The relationship between health literacy and happiness was explored using a cross-sectional survey of community-dwelling older primary-care patients. Health literacy status was estimated with the following previously validated question: “How confident are you in filling out medical forms by yourself?” Happiness was measured using an adapted Subjective Happiness Scale. Of all patients (n = 383), 62% were younger than 65, 28% were men, and 39% were African–American. In bivariate analysis, health literacy was positively correlated with happiness (Spearman’s ρ = 0.261; p < 0.001). Multivariable logistic regression revealed that lowest-quartile happiness was associated with poverty (OR: 2.25; 95% CI: 1.17–4.31), unfavorable self-rated health (OR: 4.16; 95% CI: 2.34–7.40), and lower health literacy (OR: 2.31; 95% CI: 1.23–4.32). The results suggest that inadequate health literacy may be an obstacle to happiness above and beyond its effect on poverty and health, and offers partial support for the inclusion of general and health literacy scores in composite quality-of-life and human development indices. Though alternative explanations are possible, we speculate that the association between health literacy and happiness might be mediated by a sense of personal control.
KeywordsGeneral literacy Health literacy Happiness Quality of life Personal control
This project was supported in part by the Agency for Healthcare Research and Quality (AHRQ) Centers for Education and Research on Therapeutics cooperative agreement (U18-HS010389).
- ADPH, Center for Health Statistics, Division of Statistical Analysis. (2006). Alabama vital statistics 2004. Montgomery, AL. Retrieved January 9, 2009, from http://ph.state.al.us/chs/HealthStatistics/Tables/AVS%202004/AVS%20BOOK%20FINAL%2004.pdf.
- Argyle, M. (1999). Causes and correlates of happiness. In D. Kahneman, E. Diener, & N. Schwarz (Eds.), Well-being: The foundations of hedonic psychology (pp. 353–373). New York, NY: Russell Sage.Google Scholar
- Argyle, M. (2001). The psychology of happiness (2nd ed.). London: Routledge.Google Scholar
- Baker, D. W., Gazmararian, J. A., Williams, M. V., Scott, T., Parker, R. M., Green, D., et al. (2002). Functional health literacy and the risk of hospital admission among Medicare managed care enrollees. American Journal of Public Health, 92(8), 1278–1283. doi: 10.2105/AJPH.92.8.1278.CrossRefGoogle Scholar
- Campbell, A., Converse, P. E., & Rodgers, W. L. (1976). The quality of American life: Perceptions, evaluations, and satisfactions. New York, NY: Russell Sage.Google Scholar
- Chew, L. D., Bradley, K. A., & Boyko, E. J. (2004). Brief questions to identify patients with inadequate health literacy. Family Medicine, 36(8), 588–594.Google Scholar
- Chew, L. D., Griffin, J. M., Partin, M. R., Noorbaloochi, S., Grill, J. P., Snyder, A., et al. (2008). Validation of screening questions for limited health literacy in a large VA outpatient population. Journal of General Internal Medicine, 23(5), 561–566. doi: 10.1007/s11606-008-0520-5.CrossRefGoogle Scholar
- Gurin, G., Veroff, J., & Feld, S. (1960). Americans view their mental health: A nationwide interview survey. New York, NY: Basic Books.Google Scholar
- Hussey, L. C., & Gilliland, K. (1989). Compliance, low literacy, and locus of control. The Nursing Clinics of North America, 24(3), 605–611.Google Scholar
- Kahneman, D. (1999). Objective happiness. In D. Kahneman, E. Diener, & N. Schwarz (Eds.), Well-being: The foundations of hedonic psychology (pp. 3–25). New York, NY: Russell Sage.Google Scholar
- Kirsch, I., Jungeblut, A., Jenkins, L., & Kolstad, A. (1993). Adult literacy in America: A first look at the results of the National Adult Literacy Survey. Washington, DC: National Center for Education Statistics, U.S. Department of Education.Google Scholar
- Kutner, M., Greenberg, E., Jin, Y., Boyle, B., Hsu, Y., & Dunleavy, E. (2007). Literacy in everyday life: Results from the 2003 National Assessment of Adult Literacy. Washington, DC: National Center for Education Statistics, U.S. Department of Education.Google Scholar
- Kutner, M., Greenberg, E., Jin, Y., & Paulsen, C. (2006). The health literacy of America’s adults: Results from the 2003 National Assessment of Adult Literacy. Washington, DC: National Center for Education Statistics, U.S. Department of Education.Google Scholar
- Larson, R. (1989). Is feeling “in control” related to happiness in daily life? Psychological Reports, 64(3), 775–784.Google Scholar
- Lu, L., Shih, J. B., Lin, Y. Y., & Ju, L. S. (1997). Personal and environmental correlates of happiness. Personality and Individual Differences, 23(3), 453–462.Google Scholar
- Lysaker, J., McCormick, K., & Brunette, C. C. (2004). Hope, happiness, and reciprocity: A thematic analysis of preservice teachers’ relationships with their reading buddies. Reading Research and Instruction, 44(2), 21–45.Google Scholar
- Miller, M. J., Degenholtz, H. B., Gazmararian, J. A., Lin, C. J., Ricci, E. M., & Sereika, S. M. (2007). Identifying elderly at greatest risk of inadequate health literacy: A predictive model for population health decision-makers. Research in Social & Administrative Pharmacy, 3(1), 70–85. doi: 10.1016/j.sapharm.2006.06.001.CrossRefGoogle Scholar
- Mindes, J., & Kronenberg, F. (2005). Virtuous qualities of mind and health: An introduction to Davidson and Thurman. Advances in Mind-Body Medicine, 21(3–4), 23–24.Google Scholar
- Moon, J.-S., & Mikami, H. (2007). Difference in subjective well-being between ethnic Korean and Japanese elderly residents in an urban community in Japan. Geriatrics and Gerontology International, 7(4), 371–379.Google Scholar
- Moritsugu, K. (2006). Proceedings of the surgeon general’s workshop on improving health literacy. Bethesda, MD: National Institutes of Health. Retrieved June 18, 2008, from http://www.surgeongeneral.gov/topics/healthliteracy/pdf/proceedings120607.pdf.
- Nielson-Bohlman, L., Panzer, A. M., & Kindig, D. A. (Eds.). (2004). Health literacy: A prescription to end confusion. Washington, DC: National Academies Press.Google Scholar
- Peterson, C. (1999). Personal control and well-being. In D. Kahneman, E. Diener, & N. Schwarz (Eds.), Well-being: The foundations of hedonic psychology (pp. 288–301). New York, NY: Russell Sage.Google Scholar
- UNDP. (2007). Human development report 2007/2008. New York, NY: Palgrave Macmillan. Retrieved June 24, 2008, from http://hdr.undp.org/en/reports/global/hdr2007-2008/.
- White, S. (2008). Assessing the Nation’s health literacy. Key concepts and findings of the National Assessment of Adult Literacy. Chicago, IL: American Medical Association Foundation.Google Scholar
- Witter, R. A., Okun, M. A., Stock, W. A., & Haring, M. J. (1984). Education and subjective well-being: A meta-analysis. Educational Evaluation and Policy Analysis, 6(2), 165–173.Google Scholar