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Health Literacy and Happiness: A Community-based Study

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Abstract

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.

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Notes

  1. Accessed on January 9, 2009.

  2. The claim that happiness is a positive outcome does not commit us to the view that happiness is the “ultimate” goal of economic, health, and social policy, as some have suggested.

  3. The concept of personal control is closely related to locus of control—“the degree to which individuals believe the things that happen to them are due to internal versus external factors” (Cooper et al. 1995, p. 398)—and to empowerment—“a sense of control over one’s life in personality, cognitive and motivation” (Koelen and Lindström 2005, p. S11).

  4. Statewide demographic data come from the Alabama Department of Public Health (ADPH 2006, p. 88).

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Acknowledgments

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).

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Authors and Affiliations

  1. Department of Philosophy, University of Alabama at Birmingham, Birmingham, AL, USA

    Erik Angner

  2. Center for Education and Research on Therapeutics of Musculoskeletal Diseases, University of Alabama at Birmingham, Birmingham, AL, USA

    Erik Angner, Midge N. Ray, Kenneth G. Saag & Jeroan J. Allison

  3. Center for Outcomes and Effectiveness Research and Education, University of Alabama at Birmingham, Birmingham, AL, USA

    Erik Angner, Midge N. Ray, Kenneth G. Saag & Jeroan J. Allison

  4. Clinical and Administrative Sciences, College of Pharmacy, University of Oklahoma, Tulsa, OK, USA

    Michael J. Miller

  5. School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA

    Midge N. Ray

  6. Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA

    Jeroan J. Allison

  7. Department of Finance, Economics, and Quantitative Methods, University of Alabama at Birmingham, Birmingham, AL, USA

    Erik Angner

  8. Division of General Internal Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA

    Jeroan J. Allison

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  1. Erik Angner
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Correspondence to Erik Angner.

Appendix

Appendix

1.1 Modified Happiness Items

  1. 1.

    How happy do you consider yourself to be in general? 1 means that you do not consider yourself to be a very happy person and 7 means that you consider yourself to be a happy person.

  2. 2.

    How do you compare your happiness to that of other people? 1 means that you are less happy than most people and 7 means that you are more happy than most people.

  3. 3.

    Some people are generally very happy. They enjoy life regardless of what is going on, getting the most out of everything. How well does this describe you? 1 means that the statement does not describe you at all and 7 means that it describes you a great deal.

  4. 4.

    Some people are generally not very happy. Although they are not depressed, they never seem as happy as they might be. How well does this describe you? 1 means that the statement does not describe you at all and 7 means that it describes you a great deal.

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Angner, E., Miller, M.J., Ray, M.N. et al. Health Literacy and Happiness: A Community-based Study. Soc Indic Res 95, 325–338 (2010). https://doi.org/10.1007/s11205-009-9462-5

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