Does health literacy promote COVID-19 awareness? Evidence from Zhejiang, China

Abstract

BackgroundHealth literacy (HL) is considered a crucial determinant of disease prevention and control. However, the role of HL in the Coronavirus Disease 2019 (COVID-19) pandemic has not been studied using provincial representative data among Chinese residents. This study aimed to assess the association between HL and COVID-19 awareness among Zhejiang residents based on the 2020 China Health Literacy Survey (CHLS).MethodsThe study was conducted among 5,596 residents aged 15–69 in Zhejiang using multistage, stratified, and probability proportional to size sampling. COVID-19 awareness and HL were assessed using the “Chinese Citizen Health Literacy Questionnaire (2020)” in Zhejiang. The covariates were divided into predisposing factors, enabling factors, and need factors according to Anderson's model. Data were analyzed by the chi-square test and logistic regression.ResultsThe study showed that HL and COVID-19 awareness levels of residents were 24.84% and 8.06%, respectively, in Zhejiang in 2020. After adjusting for covariates, residents with adequate HL were more likely to have better COVID-19 awareness (odds ratio [OR] = 5.22, 95% CI = 4.13–6.59, p < 0.001). Three dimensions of HL (knowledge and attitudes, behavior and lifestyle, and health-related skills) were associated with COVID-19 awareness. Additionally, COVID-19 awareness was associated with age, occupation, family size, annual household income, and chronic conditions.ConclusionCOVID-19 awareness is significantly associated with HL, suggesting that promoting HL is an important component of health education, disease prevention, and health promotion in response to the COVID-19 pandemic and even possible public health emergencies in the future.

Topics Included in Health Literacy Studies in Asia: A Systematic Review

“…In 89 relevant papers in HL, studies authored by Chinese scientists are the most prevalent, with 27 studies that surveyed HL levels in various groups of people. They were patients 22 -27 or general public, secondary, 28 -30 high school, 30,31 college students, 32,33 women, 34 12 years old and above, 16,15,35 -43 or older adults. 44 -47 Taiwan had the second-highest number of HL measurement articles, with 16 published papers.…”

“…Based on the characteristics of the population in these studies, the percentages of inadequate, low, or limited HL levels varied between 3.5% (among 4589 cancer patients in China) 24 and 84.5% (among 1360 community residents aged 15-69 years in Shanghai). 37 The most common determinants associated with their HL level were age, 13,15,16,24,36,15,40,41,44,45,53 -70 education, 13,16,24,30,32,15,35 -37,39,40,44,45,50,52 -58,60 -66,68,71 …”

Impact of long COVID-19 on posttraumatic stress disorder as modified by health literacy: an observational study in Vietnam

“…Health literacy is not only essential during the COVID-19 pandemic, but it will also be critical and urgent in post-COVID health crises [ 84 ,85]. People with a high level of health literacy will be more aware of their COVID-19 status, better understand COVID-19 symptoms, more accurately identify behaviors to prevent infection, and more readily accept COVID-19 vaccination [ 39 , 86 ]. The COVID-19 pandemic highlights the importance of developing health literacy for personal and community self-protection [ 84 , 87 ].…”

Disparities in the level of COVID-19 health literacy and the associated factors among employees in long-term care facilities in Taiwan

“…COVID-19 awareness is significantly associated with health literacy [ 25 ], therefore, addressing the health literacy, language and cultural needs of the community in public health messaging about COVID-19 must now be a priority [ 12 ]. Health literacy and COVID-19 knowledge could be improved using diverse information sources, such as using digital media and face-to-face communication [ 26 ].…”