The relationship between health literacy and happiness was explored using a cross-sectional survey of community-dwelling older primary-care patients. Health literacy status was estimated with the following previously validated question: "How confident are you in filling out medical forms by yourself?" Happiness was measured using an adapted Subjective Happiness Scale. Of all patients (n = 383), 62% were younger than 65, 28% were men, and 39% were African-American. In bivariate analysis, health literacy was positively correlated with happiness (Spearman's ρ = 0.261; p < 0.001). Multivariable logistic regression revealed that lowest-quartile happiness was associated with poverty (OR: 2.25; 95% CI: 1.17-4.31), unfavorable self-rated health (OR: 4.16; 95% CI: 2.34-7.40), and lower health literacy (OR: 2.31; 95% CI: 1.23-4.32). The results suggest that inadequate health literacy may be an obstacle to happiness above and beyond its effect on poverty and health, and offers partial support for the inclusion of general and health literacy scores in composite quality-of-life and human development indices. Though alternative explanations are possible, we speculate that the association between health literacy and happiness might be mediated by a sense of personal control. © 2009 Springer Science+Business Media B.V.