The working population's health literacy and changes in physical activity over one year.

BACKGROUND: This study attempted to clarify the relationship between HL and starting and/or maintaining physical activity in the working generation through a one-year follow-up study of a large company's employees. METHODS: Participants included 6060 employees aged 18-64 in a company in rural Japan. In 2019, health literacy was evaluated using the Japanese version of the HLS-EU-47. Data on leisure-time exercise habits and daily physical activity were obtained from the company's 2019 and 2020 records. Based on combined responses from both years, participants were divided into four groups: remaining active, remaining inactive, changing from active to inactive, and changing from inactive to active. Multinomial logistic regression analysis assessed associations between health literacy and changes in leisure-time exercise and daily physical activity. RESULTS: At baseline, participants with physical exercise habits constituted 18.6%, and 39.9% engaged in physical activity daily for over an hour. Only 14.1% of all participants exercised in both 2019 and 2020, and 74.6% remained without exercise. The percentage remaining physically active daily was 29.1%, and 49.4% remained inactive. The proportion who remained active, doing leisure-time exercise and being physically active, was higher in the higher health literacy group than in the lower group. Compared to the lower health literacy group, the higher group tended to change physical activity status in both directions, from active to inactive and from inactive to active. CONCLUSIONS: HL was associated with continuing and starting exercise and being active daily. Therefore, it was suggested that improving HL effectively improves physical activity among the working population.