ArticleEnvironmental health and preventive medicine2026
COVID-19-related health literacy, general health literacy, and mental health problems: evidence from a population-based study in Japan.
Article in Environmental health and preventive medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe coronavirus disease 2019 (COVID-19) pandemic highlighted poor health literacy (HL) as an underestimated public health problem. This study aimed to examine whether COVID-19-related HL and general HL were differentially associated with mental health problems.
methodsA questionnaire survey was conducted among residents of Japanese metropolitan areas during the resurgence phase of the pandemic. Data from 1,482 participants were analyzed. COVID-19-related HL was assessed by participants' perceived difficulty in understanding COVID-19-related information and recommendations. General HL was measured using the Communicative and Critical Health Literacy scale. Mental health outcomes included psychological distress, mood and anxiety disorders, and COVID-19-related anxiety. Multiple logistic regression analyses were conducted to estimate odds ratios (ORs) and 95% confidence intervals (CIs) per one-standard deviation increase in each HL measure, adjusting for age, sex, education, income, work status, self-rated health, and the other HL measure.
resultsThe correlation coefficient between the two HL measures was 0.195. Higher COVID-19-related HL was associated with decreased risks of mental health problems; the ORs were 0.70 (95% CI, 0.62-0.78) for psychological distress, 0.76 (95% CI, 0.66-0.88) for mood and anxiety disorders, and 0.66 (95% CI, 0.53-0.81) for COVID-19-related anxiety. General HL was not associated with mental health problems; the corresponding ORs were 0.95 (95% CI, 0.85-1.06), 0.90 (95% CI, 0.79-1.03), and 1.11 (95% CI, 0.90-1.36), respectively.
conclusionsHigher COVID-19-related HL, but not general HL, was associated with decreased risks of mental health problems.
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