We sought to develop and evaluate a health literacy measure in a multi-national study and to examine demographic characteristics associated with health literacy. Data were obtained from Demographic Health Surveys conducted between 2006–15 in 14 countries in Sub-Saharan Africa. Surveys were the same in all countries but translated to local languages as appropriate. We identified eight questions that corresponded to the National Academy of Medicine (NAM) definition of health literacy. Factor analysis was used to extract one measure of health literacy. Logistic regression was employed to examine the relationship between demographic characteristics and health literacy. A total of 224 751 individuals between the ages of 15 and 49 years were included. The derived health literacy measure demonstrated good internal consistency (Cronbach’s α = 0.72) and good content validity. The prevalence of high health literacy overall was 35.77%; females 34.08% and males 39.17%; less than or equal to primary education 8.93%, some secondary education 69.40% and ≥complete secondary 84.35%. High health literacy varied across nations, from 8.51% in Niger to 63.89% in Namibia. This is the first known study to evaluate a measure of health literacy relying on the NAM definition utilizing a large sample from 14 countries in Sub-Saharan Africa. Our study derived a robust indicator of NAM-defined health literacy. This indicator could be used to examine determinants and outcomes of health literacy in additional countries.

One in four American adults has a disability. Individuals with disabilities are more likely to have mental health issues and use substances and are less likely to attend substance use rehabilitation compared to individuals without disabilities. However, most research about substance use and substance use rehabilitation does not focus specifically on sensory disabilities. The purpose was to test the association between vision and/or hearing loss, lifetime drug use, and lifetime drug rehabilitation. Data files from National Health and Nutrition Examination Survey cycles (2013-2014, 2015-2016, 2017-2018) were combined. Ordinal logistic regression was used to test the association between vision and hearing loss and lifetime drug use and binary logistic regression to test the association with lifetime rehabilitation among those who had used drugs, adjusting for multiple testing and the complex survey design. There was a significant association between vision and hearing loss status and lifetime drug use (p = .018), but not with lifetime rehabilitation (p = .972). Post-hoc comparisons were not statistically significant. However, individuals with vision loss only and hearing loss only had 36% and 37% greater odds, respectively, of drug use than those without a disability, and those with both vision and hearing loss had 18% greater odds of drug use than those with either alone. Persons with disability were more likely to have used drugs but were not more likely to have gone to drug rehabilitation.