Health literacy levels in young adults in Northern Norway and their ability to find and judge health information: a Fit Futures 3 study

Abstract Background The digital transformation of health services forms the context in which young adults find and critically evaluate health information. Young adults are of particular interest as they navigate this environment during a formative life stage of growing health autonomy. Within the health literacy framework, finding and judging health information represent distinct competencies, but patterns on specific finding and judging items across sociodemographic groups remain understudied. This study examines health literacy levels and patterns on selected finding and judging items among young adults in Northern Norway. Methods Cross-sectional analyses used data from the Fit Futures 3 cohort (FF3, 2021–2022; n = 538, median age 27, range 26—36). Health literacy was measured using HLS-Q12-NO. Primary outcomes were the prorated sum score and health literacy level, secondary outcomes were five HLS-Q12 items (three finding, two judging). A prorated score was calculated for the 177 participants (33%) with one or two missing items. Explanatory variables were sex, educational level, current and childhood financial situation, and self-reported health. Sum score differences were examined with t-tests and ANOVA, item-level associations with Kruskal–Wallis tests and Benjamini–Hochberg FDR correction. A sensitivity analysis assessed robustness. Results The mean HLS-Q12 prorated sum score was 37.4 (SD = 5.2, range 24—48); 21% scored in the two lowest health literacy categories (levels 1—2, ≤ 33). Significant associations were found for sex ( p = .012), educational level ( p = .001), childhood financial situation ( p = .003), current financial situation ( p < .001), and self-reported health ( p < .001). Perceived difficulty was strongly associated with health literacy level across all five items (ε 2 = .315–.464). Judging was generally more difficult than finding (most p < .001), except Q5 versus Q7 ( p = .074). Judging treatment options (Q3) was the most difficult item (35.6%). Males reported greater difficulty with Q5 ( p = .001, ε 2 = .020). After FDR correction, Q3 was associated with self-reported health ( p < .001, ε 2 = .033) and Q7 with educational level ( p = .019, ε 2 = .013). Conclusion Judging health information was more challenging than finding it, consistently across sociodemographic groups. Self-reported health showed the largest unadjusted associations with difficulty on the selected items, while socioeconomic variables showed smaller and less consistent associations. Strategies to strengthen health literacy among young adults should prioritize critical appraisal skills.