Health literacy and its influencing factors among the chronically ill: insights from a population survey

Abstract Health literacy (HLIT) is critical for effective self-care in managing chronic illnesses and their outcomes, necessitating targeted interventions. However, existing research is limited in size and scope. This study analysed the status and influencing factors of HLIT among chronically ill individuals in South Korea using a population-based national survey from the Korea Health Panel Survey. From March to July 2021, data were collected from 5652 respondents who reported at least one chronic condition. HLIT was assessed using the 16-item European Health Literacy Survey Questionnaire adapted for the Korean context. Bivariate and multiple linear regression analyses were performed. The mean HLIT score was 10.48, which is slightly lower than those of the general population of Korea and other countries. Bivariate results indicated that individuals aged 70 years or older, females, those with lower socioeconomic status, those living in rural areas, and those with three or more chronic conditions had the lowest HLIT levels. Multivariate analysis revealed that older age, female sex, unemployment, single status, lower education and income, and a higher number of chronic diseases were associated with lower HLIT levels. Additionally, the most significant challenge facing chronically ill individuals with relatively low HLIT was finding or using information to manage their conditions. These findings suggest that people with chronic illnesses experience heightened HLIT-related challenges, compounded by managing multiple chronic conditions, broader disparities, and social determinants of health. Future interventions should address the specific barriers chronically ill individuals face to promote HLIT and improve health outcomes in this vulnerable population.