The Effects of Health-Promoting Behavior, Health Self-Efficacy, and Health Literacy on Aging Anxiety among Late Middle-Aged Adults: A Cross-Sectional Descriptive Study

Purpose: This study aimed to investigate the levels and correlations of health-promoting behavior, health self-efficacy, health literacy, and aging anxiety, and the factors influencing aging anxiety in late middle-aged adults. Methods: The subjects included 164 late middle-aged adults aged 50–64 years residing in B metropolitan city, South Korea. An online questionnaire was administered through a professional online research company from June 10th to 16th, 2025 to assess general characteristics, health-promoting behavior, health self-efficacy, health literacy, and aging anxiety. Collected data were analyzed using descriptive statistics, independent t-tests, one-way ANOVA with Duncan tests, Pearson correlation coefficients, and multiple linear regression. Results: A total of 164 subjects with a mean (±SD) age of 56.70 (±4.08) years were included in the final analyses. Aging anxiety had significant negative correlations with health-promoting behavior (r=-.38, p<.001), health self-efficacy (r=-.31, p<.001), and health literacy (r=-.17, p=.029). In the final multiple regression analysis, having one chronic disease (β=.24, p=.003), subjective health rated as ‘average’ (β=.28, p=.002) and ‘poor’ (β=.29, p=.010), and perceived economic status rated as ‘moderate’ (β=.33, p=.008) and ‘low’ (β=.34, p=.010) were associated with higher aging anxiety, whereas higher health-promoting behavior (β=-.23, p=.003) and health self-efficacy (β=-.21, p=.010) were associated with lower aging anxiety. The model explained 33% of the variance in aging anxiety (F=8.93, p<.001). Conclusion: Enhancing health-promoting behavior and health self-efficacy and improving chronic disease management, subjective health, and economic stability of late middle-aged adults will ultimately reduce their aging anxiety and positively impact their psychological well-being and healthy aging.