Limited Functional Health Literacy, Health Information Sources, and Health Behavior among Community-Dwelling Older Adults in Japan

The objectives of this study were to explore how health information sources vary by functional health literacy levels and the relationship between health literacy and health behaviors among the old-old, community-dwelling adults. A cross-sectional study was used. The sample included 620 participants from a rural community in northern Japan. We used structured questionnaires to gather demographic information and assess health-related behaviors, information sources utilized, and functional health literacy. Functional health literacy scores were categorized into three groups, namely, low, middle, and high literacy. Individuals with limited health literacy were more likely to drink less alcohol, were less physically active, had less dietary variety, and had a low rate of medical check-ups. They were also less likely to use printed media, organization or medical procedure, electronic media, and accessed fewer health-related information sources. This study highlights the necessity of information tools that facilitate better access to information among older adults with limited health literacy. 1. Introduction Limited health literacy is a barrier to adequate health care. Health literacy is defined as “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions” [1]. People with limited health literacy typically have a poor understanding of their medical condition and medical prescriptions, as well as poorer disease management, making it difficult for them to make good decisions regarding various aspects of their health [2]. Limited health literacy among older adults is a major concern because it has implications for their overall health. Previous research has shown a limited health literacy rate of around 24% [3–5] among community-dwelling older adults. Therefore, in the interests of community service, it is important to consider ways of providing health information to older adults who have limited health literacy. Previous studies have shown that limited health literacy is independently associated with a poorer health status, inclusive of physical and mental health [4], as well as mortality [6–9]. Older adults with limited health literacy have a poor understanding of health-related information [10] and tend to have limited access to health care services [3, 11]. Thus, health care access may act as a mediator between limited health literacy and poor health status among older adults. Furthermore, varying health literacy levels may contribute to disparities