This report used data from the Programme for the International Assessment of Adult Competencies (PIAAC), an international survey of about 250 000 adults aged 16-65 years, conducted from 2011-2015 in 33 countries/national sub-regions to assess the relationship between general literacy skills and health status. Across countries, there was a strong and consistent association between general literacy proficiency and self-rated poor health, independent of the influence of prior socio-economic status and income. General literacy proficiency also appeared to be a mediator of the association between self-education and self-rated poor health. While the literacy-health association is robust over time, it varies in magnitude across countries. It is strongest for those with a tertiary or higher degree and does not appear to exist among young adults (ages 25 to 34 years). The authors argue that these findings are critical for policy development as they may be related to differences in the quality of the formal education and training individuals received, and to differences in the opportunities for skill development and consolidation individuals experienced after they completed formal education.