Health literacy status and associated factors among residents in Anhui Province, China: a cross-sectional study

Health literacy (HL) is a critical determinant of health outcomes. Improving HL stands as one of the most essential, cost-effective, and efficacious strategies for enhancing the overall health of the population. This study aims to analyze the status of HL among urban and rural residents in Anhui Province, explore the associated factors, and provide a scientific basis for the formulation of targeted health education and promotion strategies.

A cross-sectional survey was conducted on 16,080 non-collective residents in Anhui Province from July to September 2022. Participants were selected using a multi-stage stratified random sampling method. HL was measured using the Chinese Citizen Health Literacy Questionnaire. Multivariable logistic regression analysis was performed to identify factors associated with adequate HL.

Overall, 29.60% of residents in Anhui Province had adequate HL. The proportion of adequate HL in the different cities ranged from 22.42 to 38.73%. Multivariable logistic regression analysis revealed that the proportion of individuals with adequate HL was higher for males than for females (adjusted odds ratio [aOR], 1.200; 95% confidence interval [CI], 1.086-1.326); married was higher than unmarried (aOR = 1.195, 95% CI: 1.021-1.398). Compared with illiterate/less literate, the aOR values for primary school, junior high school, senior high school, and college or above were 1.690 (1.326-2.155), 3.467 (2.760-4.356), 7.033 (5.516-8.968), and 17.895 (13.948-22.959), respectively; compared with the age group of 65-69 years, the aOR values for the age groups 15-24, 25-34, 35-44, 45-54 and 55-64 years were 2.384 (1.774-3.202), 2.598 (2.049-3.294), 2.862 (2.267-3.615), 2.135 (1.697-2.685), and 1.468 (1.157-1.863), respectively; compared with farmers, the aOR values were 1.244 (95% CI, 1.081-1.432) for technical/professional, 1.121 (95% CI, 1.003-1.254) for commercial/service, and 1.329 (95% CI, 1.163-1.518) for other occupations.

Residents of Anhui Province exhibit relatively low levels of HL, with notable disparities observed among different education levels, age groups, genders, and marital statuses. It is essential for health policymakers and public health practitioners to develop targeted health education and promotion strategies tailored to distinct subpopulations of residents.