Association between health literacy and behavior regarding health checkups and health counseling in Japanese employees: A comprehensive health literacy survey of a Japanese railway company

Abstract

Globally, health literacy is considered important for healthy ageing. However, to our knowledge, no study has investigated comprehensive health literacy in Japanese employees. This study aimed to examine comprehensive health literacy in employees of company A, a Japanese railway company, and to determine the association between health literacy and behavior regarding health checkups and health counseling in the employees. A representative sample of company A with 541 employees was selected through random sampling. We divided the sample into 20 groups based on gender, age, night shift work, and administrative position. These groups were compared with the employee distribution of company A. The self-administered Japanese version of the 47-item European Health Literacy Survey Questionnaire was distributed to the participants via mail from May 1, 2017, to May 30, 2017. This questionnaire consists of three domains, each with its own index: health care health literacy (health care health literacy index [HC-HL]), disease prevention health literacy (disease prevention health literacy index [DP-HL]), and health promotion health literacy (health promotion health literacy index [HP-HL]). Additionally, general health literacy (general health literacy index [GEN-HL]) was also assessed. Statistical analyses were performed to identify the association between health literacy and behavior regarding health checkups and health counseling in the employees in company A. Furthermore, we compared the health literacy of the present sample with that of samples in past studies by Nakayama et al. (2015) and Goto et al. (2018). A total of 417 questionnaires were returned. The health literacy scores were calculated based on the valid responses of 381 participants. The mean health literacy scores in company A for GEN-HL, HC-HL, DP-HL, and HP-HL were 25.1, 24.6, 27.9, and 22.8, respectively. The mean health literacy scores in the survey by Nakayama et al. for GEN-HL, HC-HL, DP-HL, and HP-HL were 25.3, 25.7, 22.7, and 25.5, respectively, and those in the survey by Goto et al. were 29.79, 29.23, 32.52, and 27.60, respectively. There was no significant difference between participant characteristics and GEN-HL scores. In contrast, there was a significant difference in the association between GEN-HL and health counseling in terms of the number of times health counseling was provided in the workplace. However, there was no significant difference between those who did not wish to receive health counseling and GEN -HL scores. The health literacy in railway company A was low. The results of this study and those of past studies did not demonstrate similar trends for health literacy. Additionally, GEN-HL scores were likely to increase if the number of people who wished to receive health counseling increased.