Defense Date


Graduation Date

Spring 2015


Immediate Access

Submission Type


Degree Name





School of Nursing

Committee Chair

Lynn M Simko

Committee Member

Alison M Colbert

Committee Member

Ian M Bennett


Health Disparities, Health Information Seeking Behavior, Health Literacy, Older Adults, Sources of Health Information


This descriptive study is a secondary analysis of the National Assessment of Adult Literacy (NAAL) 2003, a large scale national assessment which included health literacy. It examined the relationships between health literacy and demographic/background characteristics in older adults (age 65 and over) related to health literacy and disparities, and sources of health information. Key findings include: 1) results support most relationships described in the conceptual model and literature associated with health literacy and disparities; 2) there are similarities and difference in the utilization of health information sources based on health literacy level; and 3) the results support established health literacy predictive relationships, and identify variables (knowledge/skills, health education) that make the model more robust.

Older adults with lower health literacy have a tendency to have less income and education, rate their health as poor or fair, have visual or auditory difficulties, and need help with tasks such filling out forms, reading newspaper or writing notes. When seeking health information, older adults with lower health literacy (Below Basic/Basic) used less sources (newspapers, magazine, internet, books, radio/TV, family/friends/co-workers, doctors/health care providers) with less frequency. As health literacy increased, the number of older adults using all sources of health information increased. Doctor/health care provider was the source used by the greatest percentage of older adults "A lot" regardless of health literacy level. The internet was not a preferred source of health information with a large percentage of older adults not using it at all.

Several variables associated with lower health literacy are also linked to health disparities such as income, education, and disabilities. Future research on interventions that address the health literacy needs of older adults based with lower income and education, and disabilities may potentially impact health disparities. Results from the regression demonstrated that income, education, help with filling out forms or reading newspaper, and utilizing the following health information sources (doctor/health care provider, books, internet, and magazines) are predictive of health literacy. Only income and education are in the literature as impacting health literacy. Adding the other significant variables has the potential to make the model more robust.