A multidimensional analysis of health literacy among users of a primary care service in Florianópolis, Brazil: a cross-sectional study

Background Health literacy supports comprehension, decision-making, and navigation of healthcare systems to maintain well-being. In Brazil, few studies assess the prevalence of health literacy in this context.Aim To assess health literacy among adult users of a Primary Care Center in Florianópolis, Brazil, and to examine its associations with sociodemographic variables, morbidity, and polypharmacy.Method Cross-sectional study with adult users of the Saco Grande Health Center in Florianópolis, Brazil. Demographic, socioeconomic, morbidity, and polypharmacy data were collected. The Brazilian version of the Health Literacy Questionnaire was used, and domain means were analyzed using Kruskal-Wallis test, Welch’s t-test, and Pearson correlation.Result We had a 41.8% response rate. A total of 42.4% of participants had a chronic disease, most not polymedicated. Mean scores for health literacy domains ranged from 2.7/4 to 3.8/5. Domains with lowest averages were “Having sufficient information to manage my health” (2.7/4), “Actively managing my health” (2.7/4), and “Social support for health” (2.7/4). The domain with the highest average was “Understanding health information well enough to know what to do” (3.8/5). Individuals with at least one chronic condition had significantly higher averages in the following domains: “Feeling understood and supported by healthcare providers” (3.01/4 vs. 2.56/4), “Ability to actively engage with healthcare providers” (3.97/5 vs. 3.59/5), “Navigating the healthcare system” (3.61/5 vs. 3.27/5), and “Understanding health information well enough to know what to do” (3.95/5 vs. 3.65/5). Number of medications exhibited positive association with domains “Feeling understood and supported by healthcare providers” (R = 0.43, p < .001), “Ability to actively engage with healthcare providers” (R = 0.28, p =.015), and “Having sufficient information to manage my health” (R = 0.30, p =.007).Conclusion While conclusions are limited by low response rate, the findings suggest that individuals with greater healthcare needs develop stronger skills in navigating the healthcare system and interacting with healthcare professionals. This highlights the importance of patient-provider relationships and care continuity in primary healthcare.