BMC public health · 2026
A cross-sectional study of health literacy and health behaviors among adults in South Korea: findings from a principal component analysis.
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Shin Hyein, Kim Woohyeon
Аннотация
BACKGROUND: Health literacy and health behaviors are closely related and play key roles in health promotion. Previous studies have reported that low health literacy is associated with unhealthy behaviors. It is important to identify which latent dimensions of health literacy are particularly associated with health behaviors. This study aimed to examine the association between components of health literacy and health behaviors among South Korean adults.
METHODS: A cross-sectional study design was used with data from the Korea Health Panel Survey. The principal component analysis was applied to the HLS-EU-Q16 to extract dimensions of health literacy, and multivariate logistic regression was conducted to assess their associations with health behaviors.
RESULTS: Health literacy tertiles were significantly associated with socioeconomic status, insurance coverage, chronic disease, disability, self-rated health status, and health behaviors (p < .05). Principal component analysis identified two distinct components. Component 1 represented active engagement and the ability to access, appraise, and apply health information. Component 2 reflected a compliance-oriented dimension involving understanding and applying health-related information. Individuals with higher levels of active engagement were more likely to participate in regular physical activity (OR = 1.08, p < .01) and to attempt weight control (OR = 1.05, p < .05). By contrast, compliance-oriented health literacy was negatively associated with regular physical activity (OR = 0.93, p < .01) and positively associated with current alcohol consumption (OR = 1.10, p < .01). Similar patterns were observed in analyses stratified by educational attainment, particularly among individuals without a college education.
CONCLUSIONS: This study used principal component analysis to identify two underlying components of health literacy and demonstrated that each component had a distinct relationship with health behaviors. The findings highlight the need for policies that foster proactive health literacy and encourage active information-seeking.
METHODS: A cross-sectional study design was used with data from the Korea Health Panel Survey. The principal component analysis was applied to the HLS-EU-Q16 to extract dimensions of health literacy, and multivariate logistic regression was conducted to assess their associations with health behaviors.
RESULTS: Health literacy tertiles were significantly associated with socioeconomic status, insurance coverage, chronic disease, disability, self-rated health status, and health behaviors (p < .05). Principal component analysis identified two distinct components. Component 1 represented active engagement and the ability to access, appraise, and apply health information. Component 2 reflected a compliance-oriented dimension involving understanding and applying health-related information. Individuals with higher levels of active engagement were more likely to participate in regular physical activity (OR = 1.08, p < .01) and to attempt weight control (OR = 1.05, p < .05). By contrast, compliance-oriented health literacy was negatively associated with regular physical activity (OR = 0.93, p < .01) and positively associated with current alcohol consumption (OR = 1.10, p < .01). Similar patterns were observed in analyses stratified by educational attainment, particularly among individuals without a college education.
CONCLUSIONS: This study used principal component analysis to identify two underlying components of health literacy and demonstrated that each component had a distinct relationship with health behaviors. The findings highlight the need for policies that foster proactive health literacy and encourage active information-seeking.