Assessment of the health literacy level of Primary Health Care users in a municipality in the semi-arid region of northeastern Brazil

Abstract

Introduction: Health literacy (HL) is the ability to access, understand, evaluate, and apply health information for health promotion. Inadequate HL levels are associated with health-risk behaviors, poor treatment adherence, increased hospitalizations, and inappropriate use of services. Objectives: To assess the HL level of Primary Health Care (PHC) users in Paulo Afonso, Bahia, and to analyze the association between sociodemographic variables and health-related comprehension and decision-making skills. Methodology: This observational, analytical, cross-sectional study included 205 literate adults. Data collection employed a sociodemographic questionnaire and two measurement instruments: the Short Assessment of Health Literacy for Portuguese-speaking Adults (SAHLPA-18) and the Short Test of Functional Health Literacy in Adults (S-TOFHLA). Results: Findings showed that 57.1% of participants exhibited inadequate HL according to the SAHLPA-18. The S-TOFHLA indicated inadequate literacy in 28.3% of participants and marginal literacy in 10.2%. Analysis revealed a strong statistical correlation between the two instruments. Lower socioeconomic status and low educational attainment (p<0.0001) were associated with lower HL levels. Conclusion: The low level of HL highlights a scenario requiring greater attention from health managers and professionals, emphasizing the relationship between patients' health, education, and income.