Association between health literacy and multimorbidity: a nationwide, cross-sectional study of a Japanese population

ObjectivesTo examine the relationship between health literacy and multimorbidity.DesignNationwide cross-sectional study.SettingCommunity settings across Japan.ParticipantsCommunity-dwelling participants aged 20 years or older were selected based on a quota sampling method that adjusted for age, sex and residential area. In total, 3678 participants from the Health Diary Study, with a mean age of 52.3 years (SD, 18.2 years; 1943 (52.8%) female participants), were included.Primary outcome measureMultimorbidity, the primary outcome measure, was defined as the presence of two or more chronic diseases.ResultsOf the 3678 participants, 824 (22.4%) had multimorbidity. The mean functional health literacy (FHL) and communicative and critical health literacy (CCHL) scores were 3.2 (SD, 0.7) and 3.6 (SD, 0.9), respectively. In the univariable analysis, both scores were associated with multimorbidity (p