Health Literacy and Its Association with Non-Communicable Disease Risk Factors Among Gurkha Veterans: Insights from Western Nepal

Background Retirement of military people, such as Gurkha veterans brings transition to their social and heal behavioral life. Transitioning to retirement and settling into their community after a long military environment could pose challenges for them to continue and adopt healthy lifestyles or access correct health information and services. Health literacy (HL) of an individual gives autonomy to pursue healthy lifestyle and appropriate healthcare services. Hence, this study aimed to assess HL among Nepali Gurkha veterans and examine its association with behavioral risk factors for non-communicable diseases (NCDs) and sociodemographic characteristics. Methods A community-based cross-sectional study was conducted among 189 Nepali Gurkha veterans. Data were collected through face-to-face interviews using a structured questionnaire comprising the Health Literacy Questionnaire (HLQ), the WHO STEPwise approach to NCD risk factor surveillance (STEPS), and a sociodemographic profile. Independent samples t-tests were used to examine associations between HLQ domains and NCD risk factors. Results Participants had highest scored on the scale ‘4. Social support for health’ (mean = 3.56, 95% CI = 3.49 to 3.64), while the lowest scores were observed in scale ‘7. Navigating the healthcare system” (mean = 1.91, 95% CI = 1.80 to 2.02), scale “5. Appraisal of health information” (mean = 2.04, 95% CI = 1.96 to 2.12) and scale ‘8. Ability to find good health information” (mean = 2.2, 95% CI = 2.08 to 2.31). Veterans who had not participated in war, were retired officer cadets, abstained from tobacco, and had normal blood pressure, showed statistically significant with higher HL scores across multiple scales. Conclusions Despite strong culture of family and community support, Nepali Gurkha veterans exhibit limited overall health literacy, particularly in navigating the healthcare system. Participants those who avoid risk factors of NCD were supposed to have higher health literacy. Targeted health promotion efforts are urgently needed to enhance health literacy as critical component of NCDs prevention and control. Strengthening healthcare providers’ ability to communicate sensitively and effectively is essential to bridging the literacy gap in this vulnerable population.