Work

Health literacy in primary care users from six Spanish autonomous communities: a multicenter study of territorial variation

Year: 2026

Type: article

Abstract: Objective: Multicenter evidence comparing health literacy across Spanish autonomous communities in primary care remains scarce. We aimed to describe health literacy among adults attending scheduled nursing consultations and explore sociodemographic, clinical, and territorial differences. Methods: = 980) completed the 16-item European Health Literacy Survey Questionnaire, Ponte a 100 lifestyle questionnaire, and 13-item Orientation to Life Questionnaire. Non-parametric tests and multiple linear regression were used. Results: Among 920 participants with valid scores, 62.50% presented sufficient health literacy and 37.50% problematic or inadequate health literacy. Health literacy was largely homogeneous across sociodemographic groups. Older age was weakly associated with lower health literacy, whereas chronic disease and sense of coherence were associated with higher health literacy; lifestyle was not retained. Participants from Castilla-La Mancha and Castilla y León showed slightly lower adjusted health literacy scores. The model explained 9.50% of health literacy variability. Conclusions: Sufficient health literacy predominated, but more than one third of participants had limited health literacy, and territorial differences were small. Contextual and healthcare-related factors may shape health literacy beyond individual characteristics.

Source: Preventive Medicine Reports

DOI: 10.1016/j.pmedr.2026.103677