The relationship between health literacy and public trust in the health system: evidence from an Iranian setting

BACKGROUND: Trust is an essential aspect of human relations. In health, trust refers to an effective relationship between service recipients and service providers. Besides trust, health literacy can improve a person’s health decisions. This study was implemented to measure health literacy and public trust among clients referring to the healthcare centers of Khalkhal, Iran. METHOD: A descriptive-analytical study was conducted in the northwest of Iran. Demographic, public trust, and health literacy questionnaires were used to collect data. The data were analyzed using SPSS 26. Linear regression was also used to examine the relationship between the total score of health literacy and public trust and its domains, adjusting for demographic variables. RESULTS: A total of 809 people participated in the study. The mean score of public trust was 110.27 (SD = 10.27), and the mean score of health literacy was 117.36 (SD = 12.70). A statistically significant relationship was found between health literacy and public trust with the variables of gender, marital status, supplementary insurance, residence, economic status, education, and age (P < 0.05). A weak statistically significant correlation was found between health literacy and public trust score (r = 0.08, P = 0.02). Based on the linear regression model, health literacy was considered as a public trust predictor (β = 0.008, P < 0.05). CONCLUSION: The results confirm that health literacy is positively associated with trust in the healthcare system. Implementing practical health literacy programs across various societal levels can foster a health-literate environment. Also, it is suggested that more focus be placed on important factors to enhance public trust, including appropriate planning, coordination in service provision, improving the knowledge of service providers, respecting patient rights, establishing justice, and increasing the quality of service.