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Health literacy in Korea: findings from the 2023 Korea National Health and Nutrition Examination Survey
Sunhye Choi, Yukyeong Kang, Hyejin Kim, Kyungwon Oh
Epidemiol Health. 2025;47:e2025037.   Published online July 9, 2025
DOI: https://doi.org/10.4178/epih.e2025037
  • 7,675 View
  • 208 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
This study aimed to assess health literacy and identify vulnerable groups, providing a basis for developing health policies aimed at improving health literacy, using data from the 2023 Korea National Health and Nutrition Examination Survey (KNHANES).
METHODS
The health literacy measurement tool used in the 2023 KNHANES comprised a total of 10 items spanning the domains of disease prevention, health promotion, healthcare, and technology and resources. Health literacy was analyzed in relation to socio-demographic characteristics and major health behaviors among 5,906 adults aged 19 years or older, using the SAS program.
RESULTS
As of 2023, the overall prevalence of adequate health literacy among adults was 60.4%. Adequate health literacy was higher in women (62.2%) than in men (58.6%). Younger individuals exhibited higher levels of health literacy, with those aged 19–64 years at 65.9%, compared to only 40.3% among those aged 65 or older. Higher income and education levels were also associated with greater health literacy. Regarding health behavior characteristics, individuals practicing healthy lifestyles, such as non-smoking, engaging in physical activity, and undergoing health checkups, demonstrated higher health literacy than those who did not engage in such behaviors.
CONCLUSIONS
Six out of 10 Korean adults demonstrated adequate health literacy, but significant differences were observed according to socio-demographic characteristics (e.g., age and education) and health behaviors (e.g., smoking and physical activity). Tailored education and policy initiatives are necessary to improve health literacy, particularly targeting older adults, low-income groups, individuals with lower education, and those who do not practice healthy lifestyles.
Summary
Korean summary
2023년 국민건강영양조사를 통해 우리 국민의 건강정보이해능력을 처음으로 조사한 결과, 우리나라 성인 10명 중 6명은 적절한 건강정보이해능력을 갖고 있었다. 건강정보이해능력은 고령, 낮은 교육수준, 건강생활 비실천 등에서 낮아 취약군의 건강정보이해능력 향상을 위한 맞춤형 교육과 정보 제공 등 다양한 방안 모색이 필요하다.
Key Message
According to the results of the 2023 KNHANES—the first nationwide assessment of health literacy in Korea—6 out of 10 Korean adults had adequate health literacy. Diverse strategies—including targeted education and information provision—are needed to improve health literacy among vulnerable groups such as older adults, those with low education and individuals who do not practice healthy lifestyles.

Citations

Citations to this article as recorded by  
  • The Effects of Health Literacy, Social Support, and Health-Promoting Behaviors on Metabolic Syndrome Among Middle-Aged and Older Women Living in Rural Areas of Republic of Korea
    Eun-Kyung Lee, Yong-Sook Eo
    Healthcare.2025; 13(24): 3279.     CrossRef
Development and validation of the Health Literacy Index for the Community for the Korean National Health and Nutrition and Examination Survey
Junghee Yoon, Soo Jin Kang, Mangyeong Lee, Juhee Cho
Epidemiol Health. 2024;46:e2024061.   Published online July 10, 2024
DOI: https://doi.org/10.4178/epih.e2024061
  • 15,375 View
  • 246 Download
  • 10 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
We developed and validated the Health Literacy Index for the Community (HLIC) to assess the health literacy of the Korean population within the framework of the Korean National Health and Nutrition and Examination Survey.
METHODS
The HLIC was developed through (1) defining the conceptual framework and generating the item pool and (2) finalizing the items and identifying the cut-off value. Interviews were conducted to examine items’ face validity, and a cross-sectional survey was performed to analyze the item-response theory and Rasch models to investigate the instrument’s psychometric properties.
RESULTS
In this study of 1,041 participants, most had no difficulty understanding health information; however, 67.9% struggled to assess the reliability of health information from the Internet or media. A 4-factor structure was identified through factor analysis, leading to the exclusion of some items. This resulted in 10 items across 4 domains: (1) disease prevention, (2) health promotion, (3) health care, and (4) technology and resources. The HLIC demonstrated good internal consistency, with a Cronbach’s α of 0.87. It also showed high test-retest reliability and correlations with other health literacy instruments. A socio-demographic analysis of the HLIC revealed disparities in health literacy across various age groups, education levels, and income brackets.
CONCLUSIONS
The HLIC was developed to systematically measure health literacy in Korea’s general population. Its simplicity and conciseness ensure reliability and validity and improve its accessibility, making it particularly suitable for the broader Korean population, including those with lower literacy levels.
Summary
Korean summary
본 연구는 한국인의 건강 문해력을 평가하기 위해 지역사회 건강정보 이해능력 측정도구(Health Literacy Index for the Community, HLIC)를 개발하고 검증하였다. 그 결과, 많은 사람들이 인터 넷이나 미디어에서 얻은 정보의 신뢰성을 평가하는 데 어려움을 겪고 있으며, 연령, 교육 수준, 소 득에 따라 건강정보 이해능력 격차가 존재함을 확인하였다. 특히 본 도구는 높은 신뢰도와 타당성 을 입증하였으며, 이를 통해 한국인의 격차를 파악하고 맞춤형 개입을 위한 중요한 정보를 제공하 는 도구로서의 유용성을 확인하였다.
Key Message
This study developed and validated the Health Literacy Index for the Community (HLIC) to assess the health literacy of Koreans, finding that many had difficulties to assess its reliability from Internet or media sources, and disparities in health literacy were observed across age, education level, and income. The HLIC demonstrated strong reliability and validity, highlighting its utility for identifying health literacy gaps and informing targeted interventions in Korea.

Citations

Citations to this article as recorded by  
  • Health literacy mediates the association of education levels with engagement in leisure-time physical activity and muscle-strengthening exercise: a population-based study of Korea
    Seong-Uk Baek, Jin-Ha Yoon
    Postgraduate Medical Journal.2026; 102(1204): 140.     CrossRef
  • Validation of health literacy competencies for healthcare professionals in Korea: a psychometric evaluation study
    Soo Jin Kang, Won Ju Hwang, Chanho Park, Hae-Ra Han
    BMC Medical Education.2026;[Epub]     CrossRef
  • Health literacy and the continuum of suicidal behaviors among adults: A national survey from South Korea, 2023
    Seong-Uk Baek, Jin-Ha Yoon
    Asian Journal of Psychiatry.2026; 117: 104884.     CrossRef
  • Health literacy by occupation in Korea
    In Cheol Hwang, Hong-Yup Ahn
    Journal of Epidemiology and Community Health.2025; 79(12): 963.     CrossRef
  • Health literacy and its relationship with mental health: A nationwide Korean survey
    Yoo Jeong Lee, Ki Dong Ko, In Cheol Hwang, Hong Yup Ahn
    Asian Journal of Psychiatry.2025; 111: 104628.     CrossRef
  • Digital Health Literacy in the General Population: National Cross-Sectional Survey Study
    Junghee Yoon, Seongwoo Yang, Soo Jin Kang, Mangyeong Lee, Dokyoon Kim, Joungwon Park, Su Jin Kim, Jiyoon Han, Jungin Joo, Juhee Cho
    Journal of Medical Internet Research.2025; 27: e67780.     CrossRef
  • Cross-sectional analysis of sociodemographic factors associated with self-reported and knowledge-based health literacy in Korea using data from KNHANES 2023
    Ki Young Huh, Ildae Song
    Scientific Reports.2025;[Epub]     CrossRef
  • Health literacy in Korea: findings from the 2023 Korea National Health and Nutrition Examination Survey
    Sunhye Choi, Yukyeong Kang, Hyejin Kim, Kyungwon Oh
    Epidemiology and Health.2025; 47: e2025037.     CrossRef
  • Impact of Sleep, Mental Health, and Health Literacy on Health-Related Quality of Life in Patients with Allergic Rhinitis: A Secondary Analysis of the 2023 Korea National Health and Nutrition Examination Survey
    Gaeun Kim, Moonhee Gang
    Journal of Korean Academy of Fundamentals of Nursing.2025; 32(3): 389.     CrossRef
  • Psychometric of the Ferrer-Urbina multidimensional scale of sexual self concept (MSSSC) in the Iranian population
    Yeganeh Dadashzadeh Sangary, Mohammad Hassan Asayesh, Ali Asgharzadeh, Zahra Naghsh
    BMC Psychology.2025;[Epub]     CrossRef
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