General health literacy and associated factors among LGBTQ+ people in Oslo, Norway

Abstract Background Health literacy is critical for a healthy lifestyle and appropriate use of health services. Yet, few studies have examined the health literacy of lesbian, gay, bisexual, transgender and queer (LHBTQ+) people, a group experiencing greater physical and mental health challenges than others. This study aimed to compare the health literacy of LGBTQ+ people than that of non-LGBTQ+ people, and to identify associated factors. Methods This cross-sectional study included a stratified sample of 22,616 adults (≥ 18 years) from the City of Oslo who participated in a large public health survey from November 4th to 15th of December 2024. Of the participants, 9.0 % were classified as LGBTQ+. Data were obtained by National Population Register and a digital questionnaire. Participant's health literacy was assessed by the General Health Literacy Questionnaire Short Form (HLS19-Q12). Associated factors of health literacy among LGBTQ+ people were assessed by different regression models. Results The mean age of LGBTQ+-people was 39 years (range: 18-88 years). The majority reported to be gay or lesbian (40 %), followed by bisexual and other identity or orientation. LGBTQ+ people had lower health literacy compared to non-LGBTQ+ people (Age-adjusted mean: 69.1 vs. 71.4, Wald-test: p < 0.001). Among LGBTQ people, higher levels of health literacy were associated with being lesbian or gay, middle aged, higher education, being more economic secure, having no disability and of Norwegian origin. Also, higher levels of health literacy (per 10 points increase) were associated with a higher rate of good self-rated health (Adjusted odds ratio: 1.33, 95% CI: 1.22-1.44). Conclusions Strategies aimed at improving the health literacy of people within the LGBTQ+ community, especially in certain subgroups, could contribute to better health outcomes. Key messages • Strengthening the health literacy of the LGBTQ+ community could be a key strategy for reducing health inequalities. • Health literacy varies greatly across different LGBTQ+ groups.