ArticleFrontiers in public health2026
Health literacy and urban-rural disparities: a cross-sectional study of access, adherence, and quality of life across the neurological spectrum.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Digital health literacy and associated factors in older adult patients with chronic obstructive pulmonary disease: a latent profile analysis.Frontiers in public health · 2026Article
- Health literacy in patients with epilepsy: a narrative review of current status, influencing factors, and future directions.Frontiers in neurologyReview
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Authors and funding
3 authors.
Funding
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Abstract
Background: Health literacy is critical for chronic disease self-management, yet remains understudied in neurological populations, particularly in low- and middle-income countries. This study examined health literacy prevalence, socioeconomic determinants, and their intersectional associations with healthcare utilization and quality of life among adults with chronic neurological conditions in China. Methods: A cross-sectional survey was conducted at a tertiary hospital from March 2022 to September 2025. Health literacy was assessed using the Brief Health Literacy Screen (BHLS). We used multivariable modified Poisson regression and intersectional analysis with multiplicative interaction terms to evaluate associations with healthcare access, emergency department utilization, medication adherence, and quality of life (EQ-5D-5L). Results: Among the 1,120 participants (mean age 57.0 years, 41.6% women), low health literacy prevalence was 33.6%, ranging from 28% in epilepsy to 68% in dementia. Education was the strongest predictor (adjusted prevalence ratio [aPR] 2.42), followed by rural residency (aPR 1.42), lowest income quintile (aPR 1.52), out-of-pocket financing (aPR 1.34), and digital exclusion (no smartphone: aPR 1.28). Low health literacy was independently associated with higher emergency department utilization (aPR 1.58), poor medication adherence (aPR 1.89), and lower quality of life (adjusted Conclusion: One-third of adults with neurological conditions in China have low health literacy, with pronounced socioeconomic and geographic disparities. These findings indicate that disadvantage accumulates through independent structural pathways, supporting multi-level interventions-including rural service expansion, universal health literacy precautions, and digital inclusion strategies-to achieve health equity.
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