Analysis of the Association between Health Literacy and Health Behaviors in Korean Adults

Background: Health literacy is increasingly recognized as a key determinant of health behavior and preventive practice. This study aimed to evaluate the association between health literacy and major health behaviors in Korean adults using nationally representative data.Methods: We conducted a cross-sectional analysis using the 2023–2024 Korea National Health and Nutrition Examination Survey. A total of 11,555 adults with complete health literacy responses were included. Health literacy was assessed using a 10-item questionnaire and categorized into quartiles (Q1: lowest; Q4: highest). Current smoking, high-risk drinking, insufficient physical activity, and non-participation in health screening were evaluated. Multivariable complex-sample logistic regression analyses were performed after adjusting for demographic and clinical covariates.Results: Lower health literacy was associated with higher prevalence of current smoking, insufficient physical activity, and non-participation in health screening. In the fully adjusted model, participants in the lowest literacy group had significantly higher odds of current smoking (odds ratio [OR], 1.83; 95% confidence interval [CI], 1.44–2.32), insufficient physical activity (OR, 1.48; 95% CI, 1.26–1.74), and not receiving health screening (OR, 1.38; 95% CI, 1.16–1.65) compared with the highest group. High-risk drinking was not independently associated with health literacy.Conclusions: Health literacy was independently associated with key health behaviors and preventive practice in Korean adults. Strategies to improve population health should consider not only access to information but also individuals’ capacity to understand and use health information.