Association of Living Alone With Health Literacy in Community-Dwelling Older Adults: A 2023 Korean National Health and Nutrition Examination Survey Analysis

Background: With population aging, the number of older adults living alone is increasing. Health literacy has an important effect on the health and quality of life of community-dwelling older adults, but the relationship between living alone and health literacy is unclear. Objective: This study aimed to explore the relationship between living alone and health literacy in community-dwelling older adults. Methods: A secondary data analysis of health literacy in community-dwelling adults aged ≥65 years was performed using the 2023 Korean National Health and Nutrition Examination Survey data. Health literacy was assessed using a self-reported questionnaire. Multiple linear regression was used to analyze the factors associated with health literacy. Results: Of 1573 older adults (mean age, 72.2 years; mean health literacy score, 27.6 points), 409 (26.0%) lived alone, of whom 73.1% were women. Health literacy was directly associated with higher educational level (college or higher: β = 0.210, P < .001), being employed (β = 0.080, P = .002), and better subjective health status (good: β = 0.067, P = .038), and inversely associated with living alone (β = −0.064, P = .018), older age (β = −0.062, P = .035), and living in a rural area (β = −0.112, P < .001). Conclusion: Living alone was associated with a lower level of health literacy. Social support to improve health literacy in older adults should prioritize those living alone, living in rural areas, with lower educational levels, unemployed persons, and those with poor self-perceived health status.