Literacy and fertility: Lifecourse evidence from the National Longitudinal Survey of Youth (NLSY)

Background: Literacy is associated with many health outcomes among US adults, but little is known about its relationship with reproductive outcomes.  This study assessed the link between literacy and fertility outcomes for US women.

 

Methods: Cohort data from the National Longitudinal Survey of Youth (NLSY) were assessed to understand the relationship between literacy and fertility. NLSY participants, US youth aged 14-22 in 1979, were surveyed annually through 1994 and biannually thereafter.  Literacy was assessed in 1980 and converted to Department of Defense Reading Grade Level (RGL) for this study. In 2010, fertility outcomes were assessed, including total parity, grand multiparity, and age at first and last birth. Chi-square and multiple and logistic regression were used to understand these relationships.

Results: Of 4,684 women enrolled in 1979, 3,764 (76%) had complete data.  Of those, in 1980 543 (17%) had the lowest RGL (<5^th grade) and 524 (14%) the next lowest RGL (5^th-6^th grade). Six hundred women (16%) were nulliparous and 173 (5%) grand multiparous.  Preliminary analyses show a significant negative relationship (p<0.0001) between total parity and RGL controlling for race, 2010 educational attainment, and 1979 poverty status. Additional analyses completed by May 2014 will assess the relationship between RGL and age at first and last birth and grand multiparity.

 

Conclusions: Results echo those for other health outcomes, providing a better understanding of the role of literacy as a social determinant of health through the reproductive lifecourse. Further research is needed to assess the potential for literacy interventions to impact women’s health.