Health literacy levels and their sociodemographic, family, and health predictors among primary health care patients in urban and rural areas: a cross-sectional study

Introduction:
Health literacy (HL) plays a key role in accessing, understanding, appraising, and using health-related information within the healthcare, disease prevention, and health promotion areas. Aim of the research: To determine the level of health literacy among primary health care (PHC) patients depending on their place of residence, and to evaluate the impact of individual sociodemographic, family, and health predictors on the level of health literacy within the study group.

Material and methods:
The cross-sectional study included 566 primary health care (PHC) patients, and it was conducted between January and December 2020. The data was collected using the paper and pencil interview (PAPI) method. The research tools applied were the European Health Competence Questionnaire (HLS-EU-Q16), the Family APGAR Questionnaire, the General Health Questionnaire (GHQ-28), and the authors’ own questionnaire.

Results:
The mean age in the study group was 49.28 ±18.39 years. The respondents were mostly women (63.3%; n = 358) and came from rural areas (52.5%; n = 297). The mean HL score (HLS-EU-Q16) of urban residents was slightly higher (12.19 ±3.5) than that of the rural residents (11.91 ±4.1). Age, financial capabilities, family function (Family Apgar), and mental health condition (GHQ-28) were found to be significantly associated with HL levels in both urban and rural residents (p < 0.05).

Conclusions:
In a multivariate analysis, HL levels in urban residents were positively related to family function but negatively associated with financial capability and mental condition. Financial situation, source of income, and family function were positively associated with HL among rural residents, while gender and mental health condition were negatively associated with HL.