Factors associated with health literacy in older adults aged 65 and over: a secondary data analysis of the 2021 Korea Health Panel applying the Andersen behavioural model

Objectives Using the Korea Health Panel 2021 survey data, we identify factors associated with health literacy (HL) among older adults aged 65 years and older. Design A secondary data analysis of the 2021 Korea Health Panel survey. Setting Korea Health Panel survey. Participants Data were from 3410 older adults ≧65 years of age, drawn from the 2016 registration census of the Korea Health Panel 2021 survey, with a stratified selection approach for participants. Outcome measure To explore the factors associated with HL within the framework of the Andersen behavioural model, considering predisposing factors (age, gender, region and spouse), enabling factors (National Basic Livelihood Security recipient, education level, economic activity, usual source of care) and need factors (subjective health status, usual activities, depression/anxiety and chronic disease). Analysis Stepwise multiple regression analysis was employed to examine the factors associated with HL among the study participants within the framework of the Andersen behavioural model. Results Statistically significant associations with HL were found for predisposition factors (age, gender and residential area), enabling factors (National Basic Livelihood Security recipient, educational background and usual source of care) and need factors (subjective health status, usual activities and the presence of chronic diseases). While the National Basic Livelihood Security recipient was significant in model 2 (p=0.011), it became nonsignificant in model 3 after adding need factors (p = 0.093). Adding enabling factors to model 1 significantly increased the explanatory power (ΔR 2 =0.084, p <0.001). Similarly, incorporating need factors into model 2 improved the model fit for model 3 (F=113.21, p <0.001) and significantly enhanced explanatory power (ΔR 2 =0.017, p <0.001). Conclusions This study highlights the importance of enabling factors, such as education level and usual source of care, and need factors, such as subjective health status and chronic disease management, in improving HL among older adults. Strategies addressing these factors could enhance HL and support healthy ageing by improving access to care and tailored health information.