Prevalence and Determinants of Health Literacy among Korean Older Adults: Gender-Specific Differences from a Nationally Representative Study

Background: Health literacy (HL) is an important determinant of health outcomes, particularly among older persons who often interact with healthcare systems.However, nationally representative evidence on HL among older Koreans remains limited.This study aimed to estimate HL prevalence and identify factors associated with inadequate HL, with a particular focus on gender-specific differences.Methods: This cross-sectional study analyzed data from the 2023-2024 Korea National Health and Nutrition Examination Survey.A total of 3,787 adults were included in the analysis.HL was assessed using the Health Literacy Index for the Community, and scores of <28 indicated inadequate HL.A stepwise multivariate logistic regression model was used to identify factors associated with inadequate HL.Results: The inadequate HL group included approximately 40% of the participants.Multivariate logistic analysis revealed that, in both genders, older age, lower educational attainment, and rural residence were significantly associated with inadequate HL.Men who were currently unemployed or who currently smoked were more likely to have inadequate HL.Among women, unmarried status and the absence of private insurance were additionally associated with a higher likelihood of inadequate HL.Conclusion: A substantial proportion of older Koreans have inadequate HL, with both shared and gender-specific determinants.These findings highlight the need for targeted strategies addressing educational and geographic disparities, as well as gender-specific vulnerabilities to improve HL and promote health equity in aging populations.