Investigating the Association of Health Literacy With Health Knowledge and Health Behavior Outcomes in a Sample of Urban Community College Undergraduates

Background: There is a paucity of evidence associating health literacy metrics with adults' enhanced health knowledge, health status, health practices, or health behaviors. Purpose: Investigate whether health-literate undergraduates exhibit enhanced health knowledge, health status, health practices, or behaviors compared to non-health-literate cohorts. Methods A convenience sample of 362 urban undergraduates responded to (1) Short Test Functional Health Literacy in Adults, (2) Health Knowledge Inventory, and (3) the American College Health Association's (ACHA) National College Health Assessment. Results: Only 4 of 78 variables discriminated between subjects rated health literate and not health literate. Three of the 4 discriminating variables had a negative association between adequate health literacy and positive health outcomes. Discussion: There was no difference between undergraduates who qualified as health literate and not health literate in (1) a minimal standard of health knowledge; (2) positive health practices; (3) positive health behaviors; or (4) health status. Translation to Health Education Practice: Recommendations: (1) health literate should be replaced with the functional intervention of health educated in the nation's priorities for improving health outcomes; and (2) state governments should capitalize on preexisting public/higher education infrastructures to deliver health education to the nation's population to remediate health disparities, improve health outcomes, and address national health outcome objectives.