Health literacy and disability: differences between generations of Canadian immigrants.

Objectives: To determine whether there are differences in disability by immigrant generation and region of origin and recency of arrival in Canada, and the role of health literacy in this relationship.

Methods: A secondary analysis of the Canadian component of the 2003 International Adult Literacy and Skills Survey (IALSS) was undertaken.

Results: Compared to the third-plus generation, first-generation immigrants were less likely to report disability; these differences remained even after adjustment for sociodemographic and socioeconomic factors. No differences in disability were observed between the second- and third-plus generations. Among first-generation immigrants, those not from Europe or USA were less likely to report disability regardless of their duration in Canada. Health literacy was negatively associated with disability only in the analysis comparing generations of Canadians. However, its effect was largely accounted for by education, employment status and income.

Conclusions: First-generation immigrants were less likely to be disabled than the other generations. Education, employment and income provide important avenues through which individuals develop health literacy. Health literacy was not associated with disability among first-generation immigrants perhaps because health literacy is low in this group.