Environmental health and preventive medicine · 2026
COVID-19-related health literacy, general health literacy, and mental health problems: evidence from a population-based study in Japan.
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Murakami Keiko, Hashimoto Hideki
Аннотация
BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic highlighted poor health literacy (HL) as an underestimated public health problem. This study aimed to examine whether COVID-19-related HL and general HL were differentially associated with mental health problems.
METHODS: A questionnaire survey was conducted among residents of Japanese metropolitan areas during the resurgence phase of the pandemic. Data from 1,482 participants were analyzed. COVID-19-related HL was assessed by participants' perceived difficulty in understanding COVID-19-related information and recommendations. General HL was measured using the Communicative and Critical Health Literacy scale. Mental health outcomes included psychological distress, mood and anxiety disorders, and COVID-19-related anxiety. Multiple logistic regression analyses were conducted to estimate odds ratios (ORs) and 95% confidence intervals (CIs) per one-standard deviation increase in each HL measure, adjusting for age, sex, education, income, work status, self-rated health, and the other HL measure.
RESULTS: The correlation coefficient between the two HL measures was 0.195. Higher COVID-19-related HL was associated with decreased risks of mental health problems; the ORs were 0.70 (95% CI, 0.62-0.78) for psychological distress, 0.76 (95% CI, 0.66-0.88) for mood and anxiety disorders, and 0.66 (95% CI, 0.53-0.81) for COVID-19-related anxiety. General HL was not associated with mental health problems; the corresponding ORs were 0.95 (95% CI, 0.85-1.06), 0.90 (95% CI, 0.79-1.03), and 1.11 (95% CI, 0.90-1.36), respectively.
CONCLUSIONS: Higher COVID-19-related HL, but not general HL, was associated with decreased risks of mental health problems.
METHODS: A questionnaire survey was conducted among residents of Japanese metropolitan areas during the resurgence phase of the pandemic. Data from 1,482 participants were analyzed. COVID-19-related HL was assessed by participants' perceived difficulty in understanding COVID-19-related information and recommendations. General HL was measured using the Communicative and Critical Health Literacy scale. Mental health outcomes included psychological distress, mood and anxiety disorders, and COVID-19-related anxiety. Multiple logistic regression analyses were conducted to estimate odds ratios (ORs) and 95% confidence intervals (CIs) per one-standard deviation increase in each HL measure, adjusting for age, sex, education, income, work status, self-rated health, and the other HL measure.
RESULTS: The correlation coefficient between the two HL measures was 0.195. Higher COVID-19-related HL was associated with decreased risks of mental health problems; the ORs were 0.70 (95% CI, 0.62-0.78) for psychological distress, 0.76 (95% CI, 0.66-0.88) for mood and anxiety disorders, and 0.66 (95% CI, 0.53-0.81) for COVID-19-related anxiety. General HL was not associated with mental health problems; the corresponding ORs were 0.95 (95% CI, 0.85-1.06), 0.90 (95% CI, 0.79-1.03), and 1.11 (95% CI, 0.90-1.36), respectively.
CONCLUSIONS: Higher COVID-19-related HL, but not general HL, was associated with decreased risks of mental health problems.