Literacy impacts diet quality and may play a role in preventing anemia. This study investigated whether literacy mediates the relationships between race or poverty status and diet quality and anemia. Diet quality was evaluated using mean adequacy ratios for 1895 white and African American adults from Healthy Aging in Neighborhoods of Diversity across the Life Span study. Anemia was diagnosed by World Health Organization standards. Path analysis explored the influence of race and poverty on anemia. Anemia was diagnosed in 223 participants. The synergistic effects of poverty, race, and diet quality influence anemia. Literacy mediated the effects of race and poverty on mean adequacy ratios and anemia, highlighting the role of literacy in physical well-being.