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ORIGINAL RESEARCH article
Front. Public Health
Sec. Public Health Education and Promotion
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1520668
Exploring the relationship between health literacy and chronic diseases among middle-aged and older adults: evidence from Zhejiang, China
Provisionally accepted- 1 Hangzhou Normal University, Hangzhou, China
- 2 Zhejiang Center for Disease Control and Prevention (Zhejiang CDC), Hangzhou, Zhejiang Province, China
Background: Chronic diseases have emerged as a significant public health challenge owing to the escalating global demographic shift toward an aging population. Middle-aged and older individuals are particularly vulnerable to chronic illnesses owing to physiological and socioeconomic changes.By leveraging health literacy data from the Zhejiang Province, this study aimed to elucidate the correlation between health literacy levels and the prevalence of chronic diseases in this demographic cohort. Methods: In this cross-sectional study, a stratified multistage whole-cluster random sampling method was used to select 12,116 permanent residents aged 45-69 years from 30 monitoring sites in Zhejiang Province from June to November 2023, using the National Health Literacy Monitoring Questionnaire for the Population. Multivariate regression analysis was employed to unravel the correlation between proficiency in health education and the prevention of chronic illnesses. Results: Sex, age, income, education, self-assessed health status, and smoking status emerged as significant predictors across the different models. Notably, self-assessed health and smoking statuses were identified as confounders that significantly affected the association between health literacy and chronic diseases. Furthermore, this study explored the influence of independent variables on specific chronic diseases, such as hypertension and cerebrovascular disease, with consistent patterns observed across models. Conclusion: Health literacy is instrumental in thwarting chronic diseases among middle-aged and older individuals. Those with higher levels of health literacy are less likely to suffer from chronic diseases, and high health literacy is a protective factor against hypertension and cerebrovascular disease.
Keywords: Health Literacy, Chronic Disease, Cross-sectional study, Middle-aged and older adults, Hypertension
Received: 31 Oct 2024; Accepted: 24 Feb 2025.
Copyright: © 2025 Li, Yao, Hu, Chen, Yan, Zhang and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xuehai Zhang, Zhejiang Center for Disease Control and Prevention (Zhejiang CDC), Hangzhou, Zhejiang Province, China
Yue Xu, Zhejiang Center for Disease Control and Prevention (Zhejiang CDC), Hangzhou, Zhejiang Province, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.