2009/02/02 by Lee Sanders, Lee M. Sanders, Steven Federico +5 · 2 citations
Health Professions · Psychology · Social Sciences · #Health Literacy and Information Accessibility #Library Science and Administration #Reading and Literacy Development
paper · doi:10.1001/archpediatrics.2008.539
crossref issued 2009/02/02 · crossref published 2009/02/02 · crossref published-print 2009/02/02 · openalex publication_date 2009/02/02 · crossref created 2009/02/02 · openalex created_date 2016/06/24 · crossref deposited 2023/04/08 · crossref indexed 2026/07/30 · openalex updated_date 2026/08/01
OBJECTIVES: To assess the prevalence of low health literacy among adolescents, young adults, and child caregivers in the United States, the readability of common child-health information, and the relationship between literacy and child health. DATA SOURCES: MedLine, Educational Resources Information Center, National Library of Medicine, PsychInfo, Harvard Health Literacy Bibliography, and peer-reviewed abstracts from the Pediatric Academic Societies Annual Meetings. STUDY SELECTION: A systematic review using the following key words: health literacy, literacy, reading skill, numeracy, and Wide Range Achievement Test. MAIN OUTCOME MEASURES: Descriptive studies that used at least 1 valid measure of health literacy, studies that assessed the readability of child health information, and observational or experimental studies that included a validated measure of health literacy, literacy, or numeracy skills and an assessment of child health-related outcomes. RESULTS: A total of 1267 articles were reviewed, and 215 met inclusion and exclusion criteria. At least 1 in 3 adolescents and young adults had low health literacy; most child health information was written above the tenth-grade level. Adjusted for socioeconomic status, adults with low literacy are 1.2 to 4 times more likely to exhibit negative health behaviors that affect child health, adolescents with low literacy are at least twice as likely to exhibit aggressive or antisocial behavior, and chronically ill children who have caregivers with low literacy are twice as likely to use more health services. CONCLUSIONS: Low caregiver literacy is common and is associated with poor preventive care behaviors and poor child health outcomes. Future research should aim to ameliorate literacy-associated child health disparities.