Objective: To examine the relationship between health literacy (HL), health information access, health behavior, and health status in Japanese people.
Methods: A questionnaire survey was conducted at six healthcare facilities in Japan. Eligible respondents aged 20-64 years (n=1218) were included. Path analysis with structural equation modeling was performed to test the hypothesis model linking HL to health information access, health behavior, and health status.
Results: The acceptable fitting model indicated that the pathways linking HL to health status consisted of two indirect paths; one intermediated by health information access and another intermediated by health behavior. Those with higher HL as measured by the 14-item Health Literacy Scale (HLS-14) were significantly more likely to get sufficient health information from multiple sources, less likely to have risky habits of smoking, regular drinking, and lack of exercise, and in turn, more likely to report good self-rated health.
Conclusion: HL was significantly associated with health information access and health behavior in Japanese people. HL may play a key role in health promotion, even in highly educated countries like Japan.
Practice implications: In order to enhance the effects of health promotion interventions, health professionals should aim at raising HL levels of their target population groups.
Keywords: Health behavior; Health literacy; Health status; Japan; Path analysis.
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