The relationship between proactive health literacy and lifestyle behaviors among residents in a region of China

Objectives With the rapid pace of modern lifestyles, unhealthy behaviors such as smoking, excessive drinking, poor diet, and physical inactivity lead to increased health risks and a greater burden of chronic diseases. Proactive health, which emphasizes individual initiative in health management, is crucial for disease prevention. This study explores the relationship between proactive health literacy (PHL) and lifestyle behaviors among community residents. Methods A cross-sectional survey was conducted among 560 community residents in Anhui Province, China, using a self-designed questionnaire. Data regarding PHL (knowledge, beliefs, and behaviors), lifestyle behaviors (smoking, drinking, diet, and exercise), and self-rated health were collected. Descriptive statistics, correlation analysis (Spearman’s rho), and multiple linear regression analysis were performed. Results Among the dimensions of health literacy, knowledge scores were relatively low (median = 3.62), belief scores were high (median = 4.00), and behavior scores were in the intermediate range (median = 3.91). Correlation analysis showed that health literacy was negatively correlated with age ( r = −0.169, p < 0.05), smoking ( r = −0.150, p < 0.05), and drinking ( r = −0.103, p < 0.05) and positively correlated with education ( r = 0.192, p < 0.05) and monthly income ( r = 0.134, p < 0.05). Multiple linear regression analysis indicated that female sex ( β = 0.242, p < 0.05), higher monthly income ( β = 0.123, p < 0.05), better self-rated health ( β = −0.181, p < 0.05), and healthier dietary habits ( β = −0.134, p < 0.05) were significant predictors of higher overall PHL. Conclusion Residents’ health knowledge was insufficient, requiring strengthened health education, particularly for older adults and those with lower levels of education/income. Although health beliefs are strong, transforming them into sustained healthy actions remains a challenge. Health literacy is closely linked to lifestyle behaviors, underscoring the need for targeted interventions to promote proactive health management.