The impact of health literacy on health behaviors in individuals with diabetes: findings from a population-based survey in South Korea

Background Diabetes management requires strict self-care and education, but patients with low health literacy may find it difficult to follow numerous lifestyle recommendations, leading to poor blood sugar control, increased risk of complications, and higher treatment costs. By maintaining a healthy lifestyle, patients with diabetes can prevent or delay adverse health outcomes. Therefore, it is important to identify individuals with low health literacy and seek ways to help them easily understand and use the information they need. Methods This study utilized data from the 2021 Korea Community Health Survey, focusing on 23,262 individuals aged ≥ 30 years with diabetes. Health literacy was defined using two variables: "Understanding Health Communication" and "Understanding Written Health Information." Health behaviors were defined meeting three criteria: non-smoking, not engaging in high-risk alcohol consumption, and regular walking. Covariates included sex, age, household income, education level, region, and self-reported health status Multivariate logistic regression analysis was performed to examine the impact of health literacy on health behaviors. Odds ratio (OR) and 95% confidence intervals (CI) were calculated. Results After adjusting for all variables, individuals who found it difficult to understand health communication had an OR for engaging health behaviors of 0.91 (95% CI = 0.83–0.99) compared to those who found it easy. Similarly, those who struggled to understand written health information had an OR for health behaviors of 0.87 (95% CI = 0.79–0.96), while individuals who did not pay attention to it had an OR of 0.83 (95% CI = 0.75–0.91). Conclusions This study revealed that low health literacy and not paying attention to health information act as obstacles to practicing health behaviors. This emphasizes the need for preventive interventions such as clear communication by healthcare professionals, the use of simple language, maintaining considerate attitudes, and utilizing visual aids in printed materials.