Age-Related Patterns in Health Literacy and Health Information-Seeking Behavior in a Korean Population: Cross-Sectional Study.

BACKGROUND: Health information-seeking behavior (HISB) is a critical component of personal health management. Health literacy (HL) shapes whether and how people seek health information, but its role across age groups remains underexplored. Korea's highly digitalized information environment and rapidly aging population provide an important context for examining age-group differences in HL and HISB. OBJECTIVE: This study examined age-group differences in the association of HL with 2 related stages of HISB-HISB experience and, conditional on engagement, source-based HISB type-and assessed whether the roles of HL, education, and health-related factors differed across age groups. METHODS: Cross-sectional data from the 2020-2021 Korea Health Panel and 2021 HL Supplementary Survey (N=7910) were analyzed. HL was measured using the European Health Literacy Survey Questionnaire-16-item (HLS-EU-Q16). HISB type was classified as source-based "active seeking" or "passive acquisition" according to the respondents' top-ranked information source. Age-stratified multivariable logistic regression was used for HISB experience and type, and sensitivity analyses examined age×HL interactions and potential selection into the HISB type sample. RESULTS: Mean HL scores were lower in older age groups (14.10, SD 2.94 in ages 19-44 years vs 8.34, SD 4.65 in ≥65 years). HISB prevalence was highest in the youngest group (1072/1608, 66.7%) and lowest in the oldest group (1052/3487, 30.2%). Among those who engaged in HISB, 92.7% (993/1072) of the youngest group and 48.2% (507/1052) of the oldest group were classified in the active-seeking category. Primary age-stratified and interaction analyses showed that HL was significantly associated with HISB experience and type among adults aged 45-64 and ≥65 years, but not among those aged 19-44 years, whereas education and health-related factors were more salient among younger adults. The HL-HISB type association was sensitive to modeling selection. CONCLUSIONS: Age-group patterns were evident in HISB experience and source-based type. HL was a more prominent correlate among middle-aged and older adults, while education and health-related factors were more salient among younger adults. Age-tailored strategies that also consider structural, motivational, and digital-access factors alongside HL are needed.