Association of health literacy with health screening and influenza vaccination among older adults

Objectives: The aim of this study was to examine the relationship between health literacy and preventive health behaviors, specifically health screening and influenza vaccination, among adults aged ≥65 years. Methods: This cross-sectional study used data from the 9th Korea National Health and Nutrition Examination Survey (3rd wave, 2024). A total of 1,541 adults aged ≥65 years were included. Health literacy was categorized into inadequate, marginal, and adequate groups. Complex-sample descriptive statistics, the Rao-Scott chi-square test, and multiple logistic regression analyses were performed using IBM SPSS Statistics 21, accounting for sampling weights, stratification, and clustering. Results: Among the participants, 75.5% had undergone health screening within the previous 2 years, and 83.8% had received influenza vaccination within the previous year. Compared with the inadequate health literacy group, the adequate group had significantly higher odds of undergoing health screening (OR=1.76, 95% CI=1.06-2.90). However, health literacy was not significantly associated with influenza vaccination (OR=1.56, 95% CI=0.99-2.48). Conclusion: Health literacy was significantly associated with health screening but not with influenza vaccination among older adults. These findings suggest that the relationship between health literacy and preventive health behaviors may differ according to the type of preventive health behavior.