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Background <p>Population aging has increased the prevalence of chronic diseases among older adults and increased the need for effective health information use. However, evidence regarding how health literacy is associated with health outcomes among older adults, and whether this association varies by chronic disease status, remains limited. Accordingly, this Korean study was conducted to evaluate the association between health literacy and health-related quality of life (HRQoL) and subjective health status among older adults.</p> Methods <p>This study involved a secondary analysis of the data from the 2023 Korea National Health and Nutrition Examination Survey (KNHANES), a nationally representative cross-sectional survey. The sample included 1,568 adults aged ≥ 65 years. Health literacy was measured using the Health Literacy Index for the Community (HLIC) and classified as adequate (≥ 30) or inadequate (&lt; 30). HRQoL was measured using the eight‑item Health-Related Quality of Life Instrument (HINT‑8), and perceived health status was dichotomized as good versus fair or worse. Multivariable linear and logistic regression models were used to examine associations between health literacy and health outcomes and to assess interaction effects with chronic disease status, adjusting for sociodemographic and health-related covariates.</p> Results <p>Overall, 43.8% of participants demonstrated adequate health literacy. Adequate health literacy was associated with higher HRQoL (B = 0.023, <i>p</i> &lt; 0.001), and higher odds of reporting good perceived health status (odds ratio = 1.57, 95% CI: 1.22–2.02). However, no statistically significant interaction between health literacy and chronic disease status was observed for either outcome, indicating no evidence of effect modification.</p> Conclusions <p>The Korean study shows that health literacy is significantly associated with HRQoL and perceived health status. The pronounced gap in the technology and resources domain indicates a key vulnerability in the use of digital health information. Incorporating HL assessment into national health examinations and healthcare settings could help identify individuals with inadequate health literacy who may require prioritized educational support. At the healthcare system level, providing information and services tailored to patients’ health literacy levels may enhance their understanding, engagement, and ability to effectively manage their health.</p>

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Health literacy and health outcomes among older adults in Korea: a secondary analysis of 2023 KNHANES data

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年8月5日

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  • Hyunjeong Kwon,
  • Eunhee Lee,
  • Shin-Ae Kim,
  • Jinhee Park,
  • Jayun Kim

摘要

Background

Population aging has increased the prevalence of chronic diseases among older adults and increased the need for effective health information use. However, evidence regarding how health literacy is associated with health outcomes among older adults, and whether this association varies by chronic disease status, remains limited. Accordingly, this Korean study was conducted to evaluate the association between health literacy and health-related quality of life (HRQoL) and subjective health status among older adults.

Methods

This study involved a secondary analysis of the data from the 2023 Korea National Health and Nutrition Examination Survey (KNHANES), a nationally representative cross-sectional survey. The sample included 1,568 adults aged ≥ 65 years. Health literacy was measured using the Health Literacy Index for the Community (HLIC) and classified as adequate (≥ 30) or inadequate (< 30). HRQoL was measured using the eight‑item Health-Related Quality of Life Instrument (HINT‑8), and perceived health status was dichotomized as good versus fair or worse. Multivariable linear and logistic regression models were used to examine associations between health literacy and health outcomes and to assess interaction effects with chronic disease status, adjusting for sociodemographic and health-related covariates.

Results

Overall, 43.8% of participants demonstrated adequate health literacy. Adequate health literacy was associated with higher HRQoL (B = 0.023, p < 0.001), and higher odds of reporting good perceived health status (odds ratio = 1.57, 95% CI: 1.22–2.02). However, no statistically significant interaction between health literacy and chronic disease status was observed for either outcome, indicating no evidence of effect modification.

Conclusions

The Korean study shows that health literacy is significantly associated with HRQoL and perceived health status. The pronounced gap in the technology and resources domain indicates a key vulnerability in the use of digital health information. Incorporating HL assessment into national health examinations and healthcare settings could help identify individuals with inadequate health literacy who may require prioritized educational support. At the healthcare system level, providing information and services tailored to patients’ health literacy levels may enhance their understanding, engagement, and ability to effectively manage their health.