The Relationship between Health Literacy, Health status and Healthy behaviors among Elderly in Isfahan

Health literacy is a measure of an individual’s ability to read, comprehend, and act on medical instructions. Limited health literacy can reduce adults’ ability to comprehend and use basic health-related materials, such as prescription, food labels, health education pamphlets and articles, appointment slips and health insurance plans. Therefore, it can reduce their ability to take appropriate and timely health care actions. Nowadays, low health literacy is considered a worldwide health threat. Thus, the purpose of this study was to assess health literacy level in elderly and to investigate the relationships between health literacy and health status, as well as health care utilization and health preventive behaviors. A cross-sectional survey of 354 elderly individuals was conducted in Isfahan. The method of sampling was clustering. Health literacy was measured using the Test of Functional Health Literacy in Adults (TOFHLA). Data was collected using home interviewing. Health status was measured based on self-rated general health. Health care utilization was measured based on self-reported outpatient clinic visits, emergency room visits, and hospitalizations. Moreover, health preventive behaviors were measured based on self-reported use of preventive health services. Approximately 79.6% of adults were found to have inadequate health literacy. They tended to be older, have fewer years of schooling, lower household income, and being female. Inadequate health literacy was associated with poorer general health (P < 0.001). In addition, health literacy level was negatively associated with outpatient visits (P = 0.003) and hospitalization (P = 0.01). No significant association was found between health literacy level and emergency room utilization. Individuals with higher levels of health literacy have performed PSA (P < 0.001) and FOBT (P = 0.003) tests (in order to diagnose prostate and colorectal cancers, respectively) more than others. No significant association was found between health literacy level and mammogram in the last 2 years. Low health literacy is more prevalent in older adults. This emphasizes the importance of health literacy issue in health promotion. Therefore, with simple educational materials and effective interventions for low health literacy group, we can improve health promotion in society and mitigate the adverse health effects of low health literacy.