The Relationship among Health Literacy, Perceived Health Competence, and Functional Health Outcomes in Low Literacy Adults with Learning Disabilities and Non-Learning Disabled Adults

Abstract

Past research suggests that individuals with limited health literacy have poorer self-rated health, higher rates of hospitalization, and increased mortality. However, little is known about how learning disabilities (LD) might influence the relationship between health literacy and health outcomes. This study assessed health literacy, perceived health competence, and functional health outcomes in a sample of 49 low literacy LD adults recruited from an adult literacy program and 29 non-LD adults from the community who were matched based on age, gender, race/ethnicity, and zip code of origin (mean age = 39.92). A secondary aim was to identify the characteristics that distinguished the two groups. It was hypothesized that the relationship between health literacy and functional health outcomes would be mediated by perceived health competence. In addition to providing demographic and health information, both groups completed a test of health literacy as well as questionnaires assessing physical/emotional health outcomes and perceived health competence. Results indicate that the LD group was functioning at significantly lower levels of general and health literacy (p < .001), had worse functional health outcomes (p = .01), and lower levels of perceived health competence (p = .001). After adjusting for insurance status and number of medical diagnoses, health literacy was a significant predictor of functional health outcomes (p = .03). However, this relationship was not mediated by perceived health competence, as health literacy was not a significant predictor of the mediator. A subsequent regression model adjusting for insurance status and number of medical diagnoses revealed that perceived health competence was a significant predictor of functional health outcomes (p = .004). These findings indicate that both health literacy and perceived health competence influence functional health outcomes independently.