Factors Associated with Adequate Health Literacy among At-Risk Groups in Sam Sung District, Khon Kaen Province

Hypertension is a major global public health issue and a major cause of death globally. It is a major risk factor for heart failure, myocardial infarction, stroke, coronary heart disease, and renal failure. Accordingly, this study aimed to investigate the factors associated with adequate health literacy among an at-risk group for hypertension in Sam Sung District, Khon Kaen Province.

A Cross-sectional study was conducted between July and December 2025. The study selected a purposive sample of 1,215 high-risk individuals. Data were collected via a structured questionnaire and analyzed using STATA version 15. Multiple logistic regression was employed to determine the direction and magnitude of associations, reported as Adjusted Odds Ratios (AOR) with 95% confidence intervals (95% CI) and p-values.

After adjusting for covariates, six factors were significantly associated with adequate health literacy regarding hypertension. Females were significantly less likely to have adequate health literacy compared to males. (AOR = 0.53; 95% CI: 0.38-0.71). Individuals engaged in agriculture and wage labor demonstrated a significantly lower likelihood of adequate health literacy compared to the unemployed. (AOR = 0.27; 95% CI: 0.13-0.60) and wage laborers (AOR = 0.40; 95% CI: 0.17-0.95). Conversely, those with an average income of average income of 5,001-10,000 Baht were 1.45 times more likely to have sufficient health literacy than those earning less than 5,000 Baht (AOR = 1.45; 95% CI: 1.07-1.96) Regarding health status, individuals with diabetes had lower health literacy than those without comorbidities (AOR = 0.31; 95% CI: 0.17-0.58). Meanwhile, for hypertension preventive behaviors, participants with high levels of preventive practices had a significantly higher proportion of adequate health literacy compared to those with low levels (AOR = 5.05; 95% CI: 2.82-9.06). Lastly, participants with high levels of hypertension knowledge were significantly less likely to demonstrate adequate health literacy compared to those with low knowledge levels (AOR = 0.15; 95% CI: 0.05-0.33)

Health literacy among high-risk hypertensive individuals is significantly influenced by sociodemographic factors (sex, occupation, income), diabetic comorbidity, disease knowledge, and preventive behaviors. These findings underscore the necessity of assessing health literacy to identify vulnerable groups, particularly females and socioeconomically disadvantaged individuals. Healthcare providers should leverage these insights to design targeted educational programs and personalized interventions, ultimately improving self-care practices, encouraging healthy behaviors, and reducing cardiovascular disease risks in chronic disease management.

Our findings demonstrate that the majority of individuals at risk for hypertension still exhibit inadequate health literacy. This underscores an urgent need to educate and empower these high-risk groups to enhance their health literacy and promote healthier lifestyles, serving as a core component of community health promotion.