Relationship between health literacy, health information access, health behavior, and health status in Japanese people.
OBJECTIVE
To examine the relationship between health literacy (HL), health information access, health behavior, and health status in Japanese people.


METHODS
A questionnaire survey was conducted at six healthcare facilities in Japan. Eligible respondents aged 20-64 years (n=1218) were included. Path analysis with structural equation modeling was performed to test the hypothesis model linking HL to health information access, health behavior, and health status.


RESULTS
The acceptable fitting model indicated that the pathways linking HL to health status consisted of two indirect paths; one intermediated by health information access and another intermediated by health behavior. Those with higher HL as measured by the 14-item Health Literacy Scale (HLS-14) were significantly more likely to get sufficient health information from multiple sources, less likely to have risky habits of smoking, regular drinking, and lack of exercise, and in turn, more likely to report good self-rated health.


CONCLUSIONS
HL was significantly associated with health information access and health behavior in Japanese people. HL may play a key role in health promotion, even in highly educated countries like Japan.


CONCLUSIONS
In order to enhance the effects of health promotion interventions, health professionals should aim at raising HL levels of their target population groups.
Department of Public Health and Environmental Medicine, The Jikei University School of Medicine, Tokyo, Japan. Electronic address: suka@jikei.ac.jp.
Machi
M
Suka
Japanese Red Cross Kanto-Koshinetsu Block Blood Center, Tokyo, Japan.
Takeshi
T
Odajima
Department of Applied Biological Chemistry, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan.
Masako
M
Okamoto
Department of Pain and Palliative Medicine, The University of Tokyo Hospital, Tokyo, Japan.
Masahiko
M
Sumitani
Department of Drug Policy and Management, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan.
Ataru
A
Igarashi
Department of Health Communication, School of Public Health, The University of Tokyo, Tokyo, Japan.
Hirono
H
Ishikawa
Laboratory of Pharmaceutical Regulatory Science, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan.
Makiko
M
Kusama
Education Center for Clinical Pharmacy Practice, Showa Pharmaceutical University, Tokyo, Japan.
Michiko
M
Yamamoto
Department of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan.
Takeo
T
Nakayama
Department of Preventive Medicine, Graduate School of Sports and Health Sciences, Daito Bunka University, Saitama, Japan.
Hiroki
H
Sugimori
D022126:Access to Information; D000328:Adult; D000428:Alcohol Drinking; D044466:Asian People / Q000706:statistics & numerical data*; D015444:Exercise; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006293:Health Promotion; D006304:Health Status; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D012907:Smoking; D011795:Surveys and Questionnaires
Health behavior; Health literacy; Health status; Japan; Path analysis