Assessing health literacy and digital health literacy: evidence from Brazil's Distrito Federal

Health literacy (HL) is essential for the population to be able to find, understand, and effectively use health information and services, which has an impact on adherence to treatments and preventive care. This study aims to analyze the association between sociodemographic factors and the dimensions of the HL Questionnaire (HLQ), including digital HL. We surveyed 828 adults employing the HLQ and the eHL Scale (eHEALS). Using regression models, we evaluate the association of demographic variables and digital HL scores on each HLQ dimension. Our findings show significant associations between higher eHEALS scores, higher education levels, and better HL across most dimensions. Low income was associated with lower scores on several HLQ scales, particularly in dimensions related to understanding healthcare providers and navigating health systems. Older participants showed greater literacy in communication with providers and navigating healthcare, while younger respondents exhibited higher digital HL. Ethnic disparities were noted, especially among Black and Brown populations, who reported lower social support for health. The dimensions with lower scores were "Feeling understood and supported by healthcare providers" and "Navigating the healthcare system," showing low interactive HL levels.