Relationship between Health Literacy and Adherence to Recommendations to Undergo Cancer Screening and Health-Related Behaviors among Insured Women in Japan

BACKGROUND: Health literacy serves as a major barrier to effective preventive health behaviors, such as cancer screening, and this relationship has not been studied among insured women in Japan. We examined the relationship between health literacy and adherence to recommendations to undergo cancer screening, and health-related behaviors, among Japanese women who were insured by a health insurance society. METHODS: We conducted a cross-sectional observation study of 670 insured Japanese women. For this, we used a self-administered questionnaire to assess environments, self-rated health status, cancer screening behavior, health-related behaviors (dietary behavior, exercise frequency, alcohol consumption and smoking behavior), and health literacy. RESULTS: Among the participants, 206 completed the questionnaire (response rate, 30.7%). Fifty-seven had undergone breast and/or cervical cancer screening. The mean health literacy score was 3.44 (standard deviation = 0.68). In logistic regression models adjusted for age, self-rated economic status, and having a primary care physician, there was no statistically significant relationship between health literacy and adherence to recommendations to undergo cancer screening, and health-related behaviors. However, age and having a primary care physician were significantly associated with cancer screening and health-related behaviors. Health literacy was not found significantly associated with effective preventive health behaviors. CONCLUSIONS: The present study found no statistically significant relationship between health literacy and adherence to recommendations to undergo cancer screening and health-related behaviors. Rather, cancer screening and health-related behaviors were found related to medical support from physicians and those their own age. Further study is needed for exploring these associations among insured women in Japan.