Health literacy and its correlates among adults surveyed in Kuwait: a venue-based cross-sectional study

Health literacy is a foundational determinant of health equity, yet remains understudied in Kuwait and the broader Gulf region. This venue-based survey assessed health literacy and its sociodemographic and health-related correlates among adults surveyed in Kuwait, to inform equity-oriented health communication and community health education.

A venue-linked, electronic cross-sectional survey was conducted across all six governorates of Kuwait (February-April 2026). Adults aged 18 years or older were recruited using quota-informed convenience sampling through an electronic self-administered questionnaire distributed at selected public venues and study channels. Validated Arabic and English versions of the HLS-EU-Q16 were administered, yielding 1,846 participants (81.1% Kuwaiti; 78.4% female). Associations were examined using ANOVA (including Welch), Kruskal-Wallis tests, general linear modelling, and logistic regression, with sensitivity analyses for the sparse poor-SRH category.

The mean HLS-EU-Q16 score was 12.89 (SD = 3.42; Cronbach's α = 0.849), and 37.2% of participants surveyed had limited health literacy (inadequate 10.6%; problematic 26.5%). Finding information on mental illness was the hardest task (C8: 57% rated it easy). Self-rated health (SRH) was the factor most strongly associated with limited health literacy, showing a graded gradient robust to tests not assuming equal variances or normality (Welch and Kruskal-Wallis both p < 0.001). The association persisted in the adjusted logistic model; because only 12 participants reported poor SRH, a model collapsing poor and fair SRH gave a stable adjusted odds ratio of 4.91 (95% CI 3.00-8.03). Increasing age was independently associated with lower odds (aOR = 0.989/year, p = 0.010), whereas a sociodemographic-only model was non-significant (Nagelkerke R ² = 0.011, p = 0.217).

Over one-third of the adults surveyed in Kuwait had limited health literacy. Self-rated health was the strongest correlate in the adjusted model, though the cross-sectional design precludes causal inference. Mental health information access represents a specific, actionable gap. These findings call for accessible, culturally and linguistically appropriate community health education, system-level responsiveness, and communication strategies prioritising individuals with poorer perceived health and chronic conditions. Because the sample was venue-recruited and predominantly Kuwaiti and female, estimates apply to the surveyed population rather than all residents of Kuwait.