Health literacy and its effect on chronic disease prevention: evidence from China’s data

Lefan Liu, Xujun Qian, Zhuo Chen, Tianfeng He

Research output: Journal PublicationArticlepeer-review

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Background: Improving health literacy is an important public health goal in many countries. Although many studies have suggested that low health literacy has adverse effects on an individual’s health outcomes, confounding factors are often not accounted. This paper examines the interplay between health literacy and chronic disease prevention. Methods: A population-based sample of 8194 participants aged 15–69 years old in Ningbo were used from China’s 2017 National Health Literacy Surveillance Data. We use multivariate regression analysis to disentangle the relationship between health literacy and chronic disease prevention. Results: We find the association between health literacy and the occurrence of the first chronic condition is attenuated after we adjust the results for age and education. This might arise because having one or more chronic conditions is associated with better knowledge about chronic diseases, thus improve their health literacy. More importantly, we find health literacy is associated with a reduction in the likelihood of having a comorbid condition. However, this protective effect is only found among urban residents, suggesting health literacy might be a key factor explaining the rural-urban disparity in health outcomes. Conclusion: Our findings highlight the important role of health literacy in preventing comorbidities instead of preventing the first chronic condition. Moreover, family support could help improve health literacy and result in beneficial effects on health.
Original languageEnglish
JournalBMC Public Health
Issue number1
Early online date14 May 2020
Publication statusPublished Online - 14 May 2020


  • Health literacy, Chronic disease prevention, Risk perception, Comorbidity, China, Rural-urban disparity


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