Health literacy, worry about unmet needs for medical care, and psychological well‐being among older Chinese adults

Jia LI, Qi WANG, Xiaochen ZHOU

Research output: Journal PublicationsJournal Article (refereed)peer-review


This study aims to examine the relationship between older adults' health literacy and their psychological well-being and the role of worry about future unmet needs for medical care in mediating this relationship.

We adopted a sample of 965 older Chinese people aged 60+ (49.74% female) from the 2021 Chinese General Social Survey. A series of structural equation models (SEMs) were performed. Health literacy was measured by three items regarding older people's ability to understand medical professionals, ask them questions, and read medical instructions. A single-item question was adopted to measure participants' worry about unmet needs for future medical care. Psychological well-being was measured by three items regarding emotional problems and depressed or anxious mood in the past 4 weeks.

Worry about future unmet needs for medical care mediates the relationship between lack of health literacy and Chinese older people's psychological well-being. The indirect effect accounts for 22.3% of the total effect. The SEM model has a satisfactory model fit (goodness of fit index = 1.000, comparative fit index = 0.999, Tucker-Lewis index = 0.997, root mean square error of approximation = 0.009, standardized root mean square residual = 0.023, chi-square test = 50.96,  P = 0.321).

The findings of this study underscore the importance of improving communication quality between healthcare providers and older adults. Clinical interventions that promote health literacy and address worries about unmet needs for medical services may benefit older adults.
Original languageEnglish
Number of pages6
JournalGeriatrics and Gerontology International
Publication statusE-pub ahead of print - 5 Dec 2023

Bibliographical note

We express our sincere gratitude to the National Survey Research Center at Renmin University of China for their valuable efforts in collecting and making the CGSS (Chinese General Social Survey)data available to the public. The CGSS, initiated in 2003, stands as the pioneering national representative survey project on urban and rural households, providing invaluable data for research and analysis.

Publisher Copyright:
© 2023 The Authors. Geriatrics & Gerontology International published by John Wiley & Sons Australia, Ltd on behalf of Japan Geriatrics Society.


  • health literacy
  • health services
  • older adults
  • psychological well-being
  • worry


Dive into the research topics of 'Health literacy, worry about unmet needs for medical care, and psychological well‐being among older Chinese adults'. Together they form a unique fingerprint.

Cite this