Does health literacy mitigate vulnerability to health-related misinformation?

Abstract Background The flood of misinformation became a prominent feature of the COVID-19 pandemic. Health (HL) and e-health literacy (eHL) are believed to protect against misinformation. This main aim of the study was to assess the relationship between the susceptibility to misinformation (SUM) and two types of health literacy. Methods The analysis was based on the data from an online survey conducted among 2,200 Polish adult Internet users in November 2024. The SUM was assessed with a set of 12 health-related false statements taken from fact-checking services. The multivariable linear regression model was developed for the SUM score as a dependent variable. The effects of HL and eHL were adjusted for sociodemographic variables, political sympathies (PS), health status, the use of the Internet and social media (SM), and utilization of alternative medicine (AM). Results HL, eHL, place of residence, vocational status, PS, PRP, SM, and the use of AM were significant predictors of SUM. Respondents with inadequate, problematic, or undetermined HL were more likely to demonstrate higher SUM than those with sufficient HL (B, 95%CI: 4.12, 2.64-5.60; 1.23, 0.29-2.16, and 3.60, 2.41-4.79, respectively). Unexpectedly, persons with higher eHL tended to show higher SUM (B, 95%CI: 0.13, 0.05-0.21). Respondents who utilized AM services in the last 5 years had higher SUM than nonusers (B, 95%CI: 3.03, 1.36-4.69). The supporters of the extreme right-wing party had higher, and those voting for the main centrist party, lower SUM than supporters of the right-wing Law and Justice party (B, 95%CI: 3.20, 1.41-5.00, and -1.64, -2.80 - -0.48, respectively). Infrequent users of SM showed significantly lower SUM than the most frequent users (B, 95%CI: -1.7, -3.01 - -0.40). Conclusions The study's findings suggest that HL is a significant protective factor against misinformation. Unexpectedly, eHL demonstrates a positive relationship with SUM. Higher levels of SUM are observed among AM users. Key messages • The interventions increasing the health literacy of citizens may counteract the vulnerability to health-related misinformation. • Users of alternative medicine services are characterized by increased susceptibility to misinformation.