Sociodemographic determinants of health literacy in Bangladeshi adults with diabetes

Abstract Given Bangladesh’s rising diabetes burden and scarce data on health literacy, this study evaluated health literacy levels and associated sociodemographic factors among diabetic adults. A cross-sectional survey was conducted at Mujibur Rahman Memorial Diabetic Hospital, Kushtia, Bangladesh from November 2024 to March 2025, using face-to-face interviews with structured questionnaires. Health literacy was assessed using the 47-item European Health Literacy Survey Questionnaire. Among the 465 participants, health literacy levels were distributed as follows: 72.7% inadequate, 16.3% problematic, and 11% sufficient. Key sociodemographic factors such as gender, age, and educational attainment were associated with health literacy. Specifically, sufficient health literacy was higher among male participants (OR = 2.87; 95% CI = 1.28–6.44; p = 0.011). Older adults (OR = 0.15; 95%CI = 0.05–0.52; p = 0.002) and participants with lower educational attainment [e.g., primary education (OR = 0.02; 95%CI = 0.01–0.05; p < 0.001) and secondary education (OR = 0.04; 95%CI = 0.01–0.12; p < 0.001)] were less likely to demonstrate sufficient health literacy than their respective counterparts. Future research should both expand the geographic scope of assessment and explore underlying factors through mixed-methods approaches.