The Associations between Health Literacy and Self-Rated Health: The Mediating Role of Life Style Using the Structural Equation Modeling Approach

Abstract Background: Self-Rated Health is related to reduction of burden of diseases and health outcomes. Various factors affect Self-Rated Health. This study aimed to investigate the mediating role of lifestyle in the relationship between health literacy and Self-Rated Health. Methods: In this cross-sectional study 495 people aged 18- 65 were participated in 2023. Health literacy questionnaire by Montazeri et al., healthy lifestyle assessment questionnaire of Eshaghi et al, and Self-rated health (SRH) by a question developed by the World Health Organization were used. Structural equation modeling (SEM) was used. Statistical analysis of data was performed using STATA 14.2 software. Results: Based on the results, a significant total effect of health literacy on self-rated health (β= -0.005, P= 0.001), was identified. Life style (β = -0.004) had a direct effect on self-rated health (p < 0.005). The result from SEM indicated that health literacy exhibited a direct effect on life style (β = 78). In addition, considering that health literacy and lifestyle have a significant relationship with self-rated health, and there is a significant relationship between lifestyle and health literacy, it can be concluded that lifestyle plays a mediating role in the relationship between the two variables of health literacy and self-rated health. Conclusion: Considering the mediating role of lifestyle in the relationship between health literacy and self-rated health, to improve self-rated health, in addition to paying attention to the role of health literacy, it is necessary to take effective measures to positively change people's lifestyle.