PURPOSE Health literacy is associated with a range of poor health-related outcomes. Evidence that health literacy contributes to disparities in health is minimal and based on brief screening instruments that have limited ability to assess health literacy. The purpose of this study was to assess whether health literacy contributes, through mediation, to racial/ethnic and education-related disparities in self-rated health status and preventive health behaviors among older adults. METHODSWe undertook a cross-sectional study of a nationally representative sample of 2,668 US adults aged 65 years and older from the 2003 National Assessment of Adult Literacy. Multiple regression analysis was used to assess for evidence of mediation. RESULTSOf older adults in the United States, 29% reported fair or poor health status, and 27% to 39% reported not utilizing 3 recommended preventive health care services in the year preceding the assessment (infl uenza vaccination 27%, mammography 34%, dental checkup 39%). Health literacy and the 4 health outcomes (self-rated health status and utilization of the 3 preventive health care services) varied by race/ethnicity and educational attainment. Regression analyses indicated that, after controlling for potential confounders, health literacy significantly mediated both racial/ethnic and education-related disparities in self-rated health status and receipt of infl uenza vaccination, but only education-related disparities in receipt of mammography and dental care.CONCLUSIONS Health literacy contributes to disparities associated with race/ethnicity and educational attainment in self-rated health and some preventive health behaviors among older adults. Interventions addressing low health literacy may reduce these disparities.

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Most adults who are new to English manage to find work, raise children, and act as informed community members and citizens (Castro and Wiley, 2008). However, proficiency in English, particularly the ability to read and write the kind of English that educated adults use, goes hand in hand with access to a much broader range of information and affords a wider set of opportunities, particularly economic opportunities. Millions of the foreignborn come to the United States to find work and are a substantial and growing segment of the workforce. However, most immigrants are concentrated in entry-level low-wage jobs that cannot sustain a family (Wrigley and Powrie, 2008), and many end up working two or three minimum-wage jobs.English proficiency is an important factor affecting wages and opportunities. Some studies (Martinez and Wang, 2006) report a 46 percent wage differential between immigrants who speak English and those who do not, even after adjusting for education and work experience. Other recent studies make it clear that English proficiency and level of education function together. One analysis, for example, showed that the mean annual earnings of immigrant workers with no more than a high school education rose steadily with their self-reported level of English-speaking skill (Sum, 2007). 5 1

Providing young adults opportunities to teach older adults mobile technology may have positive impact on their attitudes towards aging and health awareness. In this presentation, the experience of 140 IMTOP college student in Taiwan who served as IMTOP volunteers for 8 weeks was analyzed qualitatively using thematic coding by 2 researchers. The volunteers received preparatory training to learn about the concepts of aging and motivational interviewing. They then provided 16-hour services to teach older adults mobile technology skills related to learning about the CDSMP and the IMTOP app. From their self-reflections, young volunteers reported that the most important things they learned from this experiences were effective communication skills with older adults and health knowledge. The intergenerational interaction broke down their stereotypes about older adults and developed their empathy and patience with better understanding of difficulties and challenges older adults encounter when using technology products. Their health awareness was also enhanced. In addition to assessing key information-processing skills --literacy, numeracy, and digital problem solving, participants also responded to an extensive background questionnaire on their educational attainment, employment, skill use at work and at home, as well as demographic questions, and questions related to health status and preventive health. SESSION 3020 (SYMPOSIUM)WHATThe PIAAC results indicate a strong relationship between age and performance in all three cognitive domains. In both literacy and numeracy domains, a smaller percentage of adults ages 45-74 performed at top proficiency levels than adults ages 25-34 and 35-44, and a larger percentage of adults ages 45-74 performed at the lowest proficiency levels compared to younger adults.The first presentation will give an overview of PIAAC and key results for older adults. The second will use PIAAC data to examine relationships between skills and variables such as participation in formal and non-formal education and training programs and employment, as well as labor force participation and income, for adults aged 45 to 65. The third presentation will examine associations between labor force participation, health status, and cognitive skills among adults aged 66 to 74. SKILLS OF U.S. OLDER ADULTS: PROGRAM FOR THE INTERNATIONAL ASSESSMENT OF ADULT COMPETENCIES (PIAAC) J. Soroui, American Institutes for Research, Washington, District of ColumbiaThis presentation is based on the results of the Program for the International Assessment of Adult Competencies (PIAAC) conducted in 2012 and 2014 in the U.S. and 33 countries. In the U.S. the study administered in 2012 and 2014 to a nationally representative sample of 8,670 adults ages 16-74. As a large-scale study, PIAAC is focused on measuring adults' key cognitive skills, including literacy, numeracy and digital problem solving, and the relationships between these skills and individuals' background and demographic characteristics. This session provides an overview of...