Exploring Health Literacy development in Spanish secondary education students

The European Health Literacy Survey only included individuals aged 15 years and older, and the competencies of adolescents in Health Literacy remain unknown. This study aimed to explore the development of Health Literacy in secondary education students and examining the relationship between this competency and relevant sociodemographic variables. A multicenter, quantitative, observational, and descriptive study with a cross-sectional design was carried out, involving the participation of all high schools in Melilla, Spain. A total of 590 students participated in the study. A validated Spanish version of the HLS-EU-Q16 questionnaire and questionnaire on sociodemographic characteristics were used. Bivariate data analysis and multivariate ordinal logistic regression were used to evaluate the association between sociodemographic characteristics and Health Literacy. The findings highlight the distinct coexistence of two cultures: European and Berber. Cultural background did not prove to be a statistically significant factor. The General Health Literacy of adolescents fell within the “problematic” range of the scale, with particularly low scores in the domain of Disease Prevention and Critical Health Literacy skills. The multivariate ordinal logistic regression analysis identified a significant association between country of birth (European vs. non-European) and a substantial increase in Health Literacy (OR: 2.65; 95% CI 1.13–6.24; p = 0.026). Large-scale surveys with multidimensional instruments are useful to reveal areas of Health Literacy in which adolescents feel most insecure and consequently need to be reinforced with educational interventions. The findings underscore the importance of considering cultural and contextual factors in Health Literacy interventions and highlight the need for targeted public health strategies to address Health Literacy disparities based on country of birth.