Multidimensional health literacy profiles and health-related behaviors in the elderly: A cross-sectional survey

OBJECTIVES: To investigate health literacy profiles using a multidimensional tool in the elderly, analyze the factors related to health literacy, and explore the relationships between health literacy and health-related behaviors. METHODS: A cross-sectional survey including 440 participants was conducted at a community health center and a village health center in Changsha, Hunan Province, between June 2020 and August 2020. We used the Health Literacy Questionnaire (HLQ) to assess the elderly’s health literacy. Sociodemographic data and health-related behaviors of them were surveyed with a self-designed questionnaire. Latent profile analysis, Pearson’s chi-squared and ordinal logistic regression were used to analyze the data. RESULTS: The median age of the 440 respondents was 68 years. The participants had the lowest scores in the “appraisal of health information” subscale (2.22 ± 0.52), followed by “navigating the healthcare system” subscale (2.89 ± 0.81) of HLQ. Based on the analysis of three profiles, respondents who were 60–74 years (OR = 2.06, 95% CI: 1.23–3.42, P = 0.006), living in urban areas (OR = 3.28, 95% CI: 2.17–4.94, P < 0.001), with secondary education or above (OR = 2.86, 95% CI: 1.92–4.27, P < 0.001), and having health insurance (OR = 1.89, 95% CI: 1.02–3.51, P = 0.042) were significantly associated with health literacy. Statistically significant associations were found between health literacy level and health-related behaviors, including medical service-seeking behavior (χ(2) = 25.14, P < 0.001), exercising regularly (χ(2) = 34.08, P < 0.001), and taking a medical examination in the past 12 months (χ(2) = 24.76, P < 0.001). CONCLUSION: The multidimensional health literacy survey has identified the low health literacy level among the elderly in community settings. It revealed the relationships of sociodemographic characteristics, including age, education level and residence, with health literacy. These findings emphasized the importance of health literacy in promoting health behaviors, guiding a profound understanding of the Chinese elderly’s health needs and health literacy to develop community-based health promotion interventions.