Does Health Literacy Affect Annual Physical Check-up?

Background and Purpose: Routine physical check-ups are associated with living a longer and healthier life. Physical check-ups assess an individual’s general health and prevent future illnesses. Previous studies have reported barriers and facilitators associated with regular check-ups, includingsocio-demographic characteristics (e.g., age and gender), accessibility to health care services (e.g., health insurance and living area), and history of diseases. Health literacy could be a critical factor in explaining the uptake of physical check-ups due to its role in accessing health care. However, little is known about how health literacy is linked to physical check-ups. This study aimed to examine the levels of physical check-ups by age group and the role of health literacy regarding physical check-ups.

Methods: Data for the study were obtained from the 2017 Health Information National Trends Survey. The original sample included 3,285 respondents, but only 3,146 surveys were used for this study. The sample was categorized into two subgroups based on age: aged 18–59 years and 60 years and older. Health literacy was measured using four items: a lot of effort to get the information, frustrated during search for the information, concerned about the quality of the information, and difficulty understanding information. Physical check-up was defined as having visited a doctor for a routine checkup within the past year (yes or no).The Andersen’s Behavioral Model of Health Services Use (Andersen, 1995) guided this study, and a binomial logistic regression model was conducted using Stata 12.0 software package.

Results: While 82.0% of the older group had an annual check-up, 67.3% of younger group had one. Both groups had similar ratios for health literacy-related item reporting. Study results show that annual check-up was positively associated with confidence in getting health information (OR = 1.184, p < 0.05, OR = 1.209, p < 0.05), health insurance (OR = 2.519, p < 0.000, OR = 2.314, p < 0.05), and having a primary doctor (OR = 2.833, p < 0.000, OR = 2.721, p < 0.000) for both age groups. However, getting a regular check-up was negatively associated with frustration while searching for information (OR = .773, p < 0.05) among the younger group and negatively associated with difficulty understanding information (OR = 1.403, p < 0.05) for the older group.

Conclusions and Implications: Our findings reported that older adults have higher level of physical check-ups than young adults. Health literacy affects the uptake of annual physical check-ups. However, different aspects of health literacy affect annual check-ups for younger and older groups. Since health literacy differs across age groups and its impact is different regarding annual check-up, intervention strategies should be tailored based on each aspect of health literacy that specifically influence each age group. Additionally, health protective factors, such as having health insurance and a primary care doctor, had a positive relationship with uptake of physical check-ups for both age groups. In addition to tailoring intervention strategies based on age group, improving health care accessibility should be considered to boost annual check-ups as it impacts both groups.