Health Literacy and the Role of Related Factors in Food Handlers: Based on a Cross-Sectional Study in Regional Malaysia

Background and Objectives: Research on food handlers has predominantly focused on food safety, neglecting the importance of health literacy. Health literacy plays a pivotal role in equipping an individual with healthy lifestyle and work practices. This study aims to assess the health literacy level of food handlers and evaluate determinants influencing their health literacy.Materials and Methods: A cross-sectional study was conducted in May-August 2023 involving 274 food handlers from 46 food outlets in Kota Marudu, Sabah, Malaysia chosen from cluster random sampling. A validated questionnaire, the Health Literacy Survey Short Form 12 (HLS-SF12) was employed to assess health literacy levels alongside sociodemographic, medical illness, healthy lifestyle practices, food handling training and recent typhoid vaccination status. The inclusion criteria are food handlers working at registered food premises, aged 18 and above. The exclusion criteria are those unable to read or comprehend English or Malay language. Frequency and percentages were used to describe the studied population while chi-square and logistic regression to determine factors associated with health literacy.Results: The majority of participants were Malaysians, female, married and possessed a secondary level of education. Among participants, 67.9% possessed good health literacy while 32.1% had low health literacy. Multiple logistic regression analysis revealed that education and under the healthy lifestyle practices factors; the annual medical examinations were significantly associated with health literacy. Food handlers who did not undergo annual medical examinations (adjusted Odds Ratio: 2.429, 95% Confidence Intervals: 1.007-5.863, p-value=0.048) and with education level below secondary (adjusted Odds Ratio: 11.305, 95% Confidence Intervals:5.735-22.287, p 0.001) were significantly associated with low health literacy. Conclusions: Promoting routine medical check-ups and having sustainable health education tailored according to educational background will enhance health literacy among food handlers, effectively empowering to make well-informed choices, thereby improving adherence to food safety protocols and promoting positive health outcomes.