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Associations of Health Literacy and Self-rated Health with Health Behavior in Korean Adults: Secondary Analysis of the 2023 Korea National Health and Nutrition Examination Survey Data

  • Global Health and Nursing
  • Abbr : Global Health Nurs
  • 2026, 16(2), pp.109~117
  • DOI : 10.35144/ghn.2026.16.2.109
  • Publisher : Research Institute of Nursing Science
  • Research Area : Medicine and Pharmacy > Nursing Science
  • Received : May 8, 2026
  • Accepted : June 25, 2026
  • Published : July 31, 2026

Cho, Yoo Mi 1,  Lee, Miseon 2

1서울대학교병원
2부산대학교 간호대학, 간호과학연구소

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ABSTRACT

Purpose: In this study, we examined the associations of health literacy and self-rated health with health behavior practices among Korean adults. Methods: A cross-sectional secondary analysis of data from 2,609 adults aged 19-64 years, with complete data on the study variables, was conducted using the 2023 Korea National Health and Nutrition Examination Survey (KNHANES) data. Health literacy was measured using a 10-item self-report tool (score range 10~40). Self-rated health was classified into three categories (positive, moderate, and negative). Health behavior was defined as meeting national physical activity guidelines and/or practicing dietary control. Complex samples analyses with stratification, clustering, and sampling weights were applied. Spearman's rank correlation and complex samples logistic regression were used to assess the independent associations of health literacy and self-rated health with health behavior, after adjusting for sociodemographic factors, current smoking, monthly alcohol use, and chronic diseases. Results: The mean health literacy score was 30.84 (SE=0.11); 62.9% of participants engaged in health behavior. Health literacy was significantly associated with health behavior in the survey-weighted unadjusted (OR=1.04, 95% CI: 1.02~1.06) and adjusted (aOR=1.03, 95% CI: 1.01~1.05, p=.014) models. For self-rated health, the positive group showed significantly higher odds of health behavior than the negative group (aOR=1.34, 95% CI: 1.02~1.76, p=.035), whereas the moderate group did not. Conclusion: Both health literacy and positive self-rated health were independently associated with health behavior. Therefore, strengthening health literacy and fostering positive self-rated health may be important considerations in nursing interventions to promote health behavior.

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