Health literacy and associated factors among selected ethnic minority communities in Yunnan, China: a cross-sectional study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background The "Directly-Entering-Socialism" ethnic minorities in Yunnan, China, represent a unique population that transitioned directly from primitive society to modern socialism. Limited data exist regarding their health literacy (HL) amidst rapid epidemiological transitions. This study assessed HL prevalence and its structural determinants within these marginalized communities. Methods A cross-sectional survey evaluated 1,375 residents using the standardized "Chinese Citizen Health Literacy Questionnaire". Statistical analyses included Chi-square tests, One-way ANOVA, Principal Component Analysis (PCA), and multiple linear regression to address multicollinearity and identify independent predictors. Results Adequate HL prevalence was critically low at 4.2% (58/1,375), characterized by a profound "knowledge-behavior gap". PCA extracted three orthogonal factors explaining 60.93% of total variance, confirming socio-demographic disadvantage—primarily driven by a strict educational gradient (OR = 3.71, P < 0.001)—as the dominant barrier. A significant occupational gradient existed (ANOVA F = 27.571, P < 0.001), with traditional farmers scoring lowest. Dimension-specific analyses revealed that high-risk behavioral clustering selectively impaired infectious disease and health information literacy. Furthermore, a severe "double burden" paradox was confirmed: adequate safety literacy plummeted from 35.1% among individuals with "Very Good" self-rated health to 4.0% in the "Very Poor" group. Crucially, a history of injury failed to improve safety literacy (28.8% vs. 29.4%, P = 0.869), empirically disproving the experiential learning hypothesis. Conclusions These transitional minorities face a severe HL deficit driven by educational disadvantages, occupational isolation, and linguistic barriers. The failure of experiential learning among physically vulnerable individuals emphasizes that cognitive vulnerabilities cannot self-correct. Culturally adapted, non-text-based primary care interventions are urgently needed to break this cycle of vulnerability.
Source: BMC Family Practice
Authors: Jian Yang, Ji Li, Qianrong Yang, Yuping Liu, Weimin Gao
Institution: Kunming Medical University
Language: English
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,790
OpenAlex ID: W7203554254