Frontiers in public health · 2026
Health literacy domains and socioeconomic inequalities in leisure-time physical activity among Korean adults.
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Seo Myong-Won
Аннотация
PURPOSE: Health literacy is an important determinant of health behavior and may contribute to socioeconomic inequalities in health-promoting behaviors. However, evidence remains limited on how total and domain-specific health literacy relate to leisure-time physical activity (LTPA) adherence and whether socioeconomic gradients in health literacy are reflected in disparities in LTPA among Korean adults.
METHODS: This cross-sectional study used data from 3,551 Korean adults aged 18-64 years who participated in the 2024 Korea National Health and Nutrition Examination Survey. LTPA was assessed using the Korean version of the Global Physical Activity Questionnaire and categorized as adherent or non-adherent according to the threshold of 150 min/week. Health literacy was assessed using a 10-item multidimensional instrument covering disease prevention, health promotion, healthcare, and technology and resources. Multivariable logistic regression analyses were conducted to estimate odds ratios (ORs) and 95% confidence interval (95% CIs) for LTPA adherence according to total and domain-specific health literacy. Socioeconomic differences in health literacy and trends in LTPA adherence across health literacy quartiles were also examined.
RESULTS: Of the 3,551 participants, 24.6% met the LTPA guideline. Higher total health literacy was independently associated with higher odds of meeting the LTPA guideline across all models (Model 1: OR, 1.066; Model 2: OR, 1.058; Model 3: OR, 1.056; all p < 0.001). All four health literacy domains were positively associated with LTPA adherence, with the strongest association observed for the health promotion domain (Model 3: OR, 1.585; p < 0.001). Health literacy showed clear gradients across household income and education levels, and LTPA adherence increased progressively across health literacy quartiles (P for trend < 0.001).
CONCLUSION: Higher health literacy was independently associated with greater adherence to LTPA guidelines among Korean adults and showed a clear socioeconomic gradient. Health literacy may represent both a behavioral determinant of LTPA and a pathway linking socioeconomic disadvantage to disparities in health-promoting activity.
METHODS: This cross-sectional study used data from 3,551 Korean adults aged 18-64 years who participated in the 2024 Korea National Health and Nutrition Examination Survey. LTPA was assessed using the Korean version of the Global Physical Activity Questionnaire and categorized as adherent or non-adherent according to the threshold of 150 min/week. Health literacy was assessed using a 10-item multidimensional instrument covering disease prevention, health promotion, healthcare, and technology and resources. Multivariable logistic regression analyses were conducted to estimate odds ratios (ORs) and 95% confidence interval (95% CIs) for LTPA adherence according to total and domain-specific health literacy. Socioeconomic differences in health literacy and trends in LTPA adherence across health literacy quartiles were also examined.
RESULTS: Of the 3,551 participants, 24.6% met the LTPA guideline. Higher total health literacy was independently associated with higher odds of meeting the LTPA guideline across all models (Model 1: OR, 1.066; Model 2: OR, 1.058; Model 3: OR, 1.056; all p < 0.001). All four health literacy domains were positively associated with LTPA adherence, with the strongest association observed for the health promotion domain (Model 3: OR, 1.585; p < 0.001). Health literacy showed clear gradients across household income and education levels, and LTPA adherence increased progressively across health literacy quartiles (P for trend < 0.001).
CONCLUSION: Higher health literacy was independently associated with greater adherence to LTPA guidelines among Korean adults and showed a clear socioeconomic gradient. Health literacy may represent both a behavioral determinant of LTPA and a pathway linking socioeconomic disadvantage to disparities in health-promoting activity.