Does Health Literacy Predict Preventive Lifestyle on Metabolic Syndrome? A Population-Based Study in Sarawak Malaysia

Poor health literacy (HL) is a risk factor for developing metabolic syndrome. In Malaysia, about 93% of adults’ population has limited HL—a huge prevalence yet understudied phenomenon. This study aims to determine the predictors of preventive lifestyles on metabolic syndrome among adult population in Sarawak are timely. This was a population-based study, conducted from September 2016 till December 2017 using a multistage stratified sampling method. Health Literacy Scale and Simple Lifestyle Indicator Questionnaire were used to measure health literacy and preventive lifestyles respectively. Analysis of Variance and logistic regression were used to analyze the data. A total of 743 respondents were involved in this study with half of them have acceptable score for health literacy (M = 46.9, SD = 6.3) and good preventive lifestyles (M = 7.3, SD = 1.4). Critical health literacy was a significant influence of preventive lifestyles. The Malay ethnic group has the highest scores for both critical health literacy [F (3, 739) = 17.82, p < 0.001] and preventive lifestyle compared to other ethnic groups [F (3, 739) = 3.12, p = 0.025]. The other Native groups scored the lowest for critical health literacy. Individual with higher score of critical health literacy tend to perform physical activities. Gender, education level, distance of health facilities, critical health literacy and employment status were identified as predictors for preventive lifestyle in this study. Health literacy is a key to preventive lifestyle behaviors in metabolic syndrome among adult population in Sarawak. Future program should focus on improving HL status with specific program targeting ethnic minorities.