Analysis of health literacy and health outcomes among farmers in border areas: an exploration based on a cross-sectional survey and structural equation modeling in South China

Background Farmers in border areas face unique health challenges, and this group’s health literacy and health outcomes are issues of social concern. Objective The aim was to use the health literacy surveillance of residents in a prefecture-level city on the border of South China as the basic information to gain a comprehensive understanding of the current status of demographic characteristics, health literacy, and health outcomes of local farmers, and to explore the correlation among the three, to provide basic information and reference basis for related research and intervention. Methods The study population was from Chongzuo City, Guangxi Zhuang Autonomous Region ( N = 2,718). A questionnaire was completed using face-to-face interviews. The questionnaire included demographic characteristics, health literacy, and self-reported health status. The data were analyzed in a basic way, and the proposed structural equation model was fitted using AMOS. Results The health literacy level of farmers in the border area of South China was 18.21, 48.38% self-reported their health as good, 18.87% suffered from chronic diseases, 7.62% suffered from accidental injuries in the past year, and median of out-of-pocket medical expenses in the past year = 300 RMB. the model fitted the data well. Demographic characteristics significantly affected health literacy and health outcomes ( p < 0.001), with standardized path coefficients of −0.603 for health literacy and 0.682 for health outcomes. Health literacy also significantly affected health outcomes ( p < 0.001), with a standardized path coefficient of 0.246. Conclusion Farmers in the borderlands of South China have a low level of health literacy, a moderate level of health outcomes, and relatively low out-of-pocket medical expenses. Targeted health education or health promotion efforts can improve farmers’ health literacy and outcomes. Among them, middle-aged and older people, those with Separated/Divorced/Widowed marital status, low education level, and low income are the groups that need to be focused on.