The association between health literacy and psychosomatic symptoms of adolescents in China: a cross-sectional study

BACKGROUND: Lower health literacy (HL) has been known to be involved in a range of common mental and physical disorders among adolescent students. Ample studies indicated low HL is associated with a series of chronic diseases even psychological diseases, nevertheless, little is known about this relationship among adolescents. In this context, the study aimed to examine associations between psychosomatic symptoms (physical and psychological symptoms) and HL in junior and senior high school students in China, and to provide guidance for improving the physical and mental health in Chinese adolescents. METHODS: A total of 22,628 junior and high school students in China were enrolled in this study. HL and psychosomatic symptoms were measured by self-report validated questionnaires. Multiple linear regression analyses were conducted to examine the associations between six sub-scales of HL and physical / psychological symptoms. RESULTS: Multiple linear regression analysis demonstrated that the sub-scales of HL showed a significantly negative association with physical symptoms and psychological symptoms (P < 0.05 for each). Physical symptoms was most strongly associated with IR (β = − 0.134), followed by SM (β = − 0.093), DB (β = − 0.059), SA (β = − 0.058) and PA (β = − 0.054). No statistically significant difference was found between HA and physical symptoms (P > 0.05). Meanwhile, psychological symptoms were most strongly associated with IR (β = − 0.160), followed by SA (β = − 0.129), SM (β = − 0.069), DB (β = − 0.031), HA (β = − 0.026) and PA (β = − 0.021). CONCLUSION: These results indicated the importance of identifying the association of HL with physical and psychological symptoms, and provided the evidence that lower HL may serve as a critical and independent risk factor for poor health outcomes. Meanwhile, to maintain students’ desirable healthy status public health efforts for enhancing their HL level are urgently needed in adolescents.