Association of health literacy with hypertension, diabetes, and dyslipidemia: A cross-sectional survey of a regional Japanese community

Abstract

Objectives This study aimed to identify how communicative and critical health literacy (CCHL) was associated with hypertension, diabetes, and dyslipidemia in a regional Japanese community.Methods A cross-sectional survey was conducted through stratified random sampling to achieve the study objectives. The sample comprised adults aged 20-75 years, residing in Ebetsu in Hokkaido, Japan. Stratification was accomplished by classifying the population into 3 districts of Ebetsu city, with 1,000 people being randomly selected from each district. A self-reporting questionnaire was then administered over July and August 2018 to these 3,000 participants. Ebetsu city officials distributed and collected the questionnaires, delivering anonymized data to the researchers. Of the 1,630 respondents, 8 did not complete the CCHL questionnaire and 43 did not fill the disease status questionnaire, so these were excluded. The final analysis was performed on the responses received from 692 men and 887 women. The CCHL scores were grouped into quartiles to identify trends related to the diseases and lifestyles. A multiple logistic regression analysis was performed to estimate the associations between CCHL and instances of hypertension, diabetes, and dyslipidemia in both sexes. The analysis was adjusted for age, living arrangement, marital status, educational attainment, current employment status, body mass index, frequency of regular exercise, habit of skipping breakfast, and smoking status.Results The overall CCHL score was computed as 3.58±0.67 (mean±SD). Among men, the prevalence of hypertension in the highest CCHL score group was significantly lower than that in the lowest CCHL group (OR 0.49; 95%CI: 0.28-0.84). The analysis indicated that the prevalence of hypertension among men was low for the highest CCHL score group (AOR 0.62; 95%CI: 0.32-1.22). Associations between CCHL scores and other diseases were found to be non-significant in both men and women.Conclusion Male participants with the highest CCHL scores had a significantly lower prevalence of hypertension than those with the lowest CCHL scores. However, these associations were found to be non-significant after adjusting for confounding factors. Future studies on the association of CCHL with lifestyle disorders should apply a longitudinal design.