Are personal health literacy and school health literacy environment important to schoolteachers health outcomes?

BackgroundWhile the relationship between an individuals personal health literacy and health outcomes is well-established, the role of the health literacy environment is often overlooked. This study aimed to examine the associations of personal health literacy and the school health literacy environment with health outcomes among schoolteachers. MethodsA cross-sectional study was conducted in 11 schools in Zhengzhou, Henan, China. Using a self-administered questionnaire, teachers (N=7364) were surveyed collecting data on their sociodemographics, personal health literacy, the school health literacy environment, and four types of health outcomes (health status, health-compromising behaviours, health service use, and healthcare cost). Besides descriptive statistics, a series of logistic regression analyses were conducted. ResultsOverall, more than half of teachers (56.9%) had inadequate or problematic health literacy, while more than three-fifths (69.0%) perceived their school health literacy environment was less supportive. Teachers with inadequate health literacy had higher odds of poor health status (odds ratio (OR)=5.79, 95% CI=3.84, 8.73), at least one health-compromising behaviour (OR=2.90, 95% CI=2.29, 3.68), at least one health service use (OR=2.73, 95% CI=2.07, 3.61), and more healthcare cost (OR=2.51, 95% CI=2.00, 3.16) than those with excellent health literacy, after adjusting for sociodemographics and school health literacy environment. Similarly, teachers who perceived low levels of supportive school health literacy environment had higher odds of poor health outcomes (ORs ranging from 1.13 to 1.78), after adjusting for sociodemographics and personal health literacy. ConclusionBoth personal health literacy and school health literacy environment are important to schoolteachers health outcomes. Educational programs and organisational change are needed to improve personal health literacy and school environments to improve teachers health and well-being.