The Community Health Supporting Environments and Residents' Health and Well-Being: The Role of Health Literacy.

We evaluate the impacts that health supporting environments have on residents' health and well-being. Using a stratified multi-stage sampling method, we select a sample of 12,360 permanent adult residents aged 15-69, and collect information on their health literacy level, as well as their demographic background and health. This individual level data is then merged with the administrative health supporting environment data. More than two thirds of residents self-reported having good/excellent health, and the percent of adults living in communities with healthy parks, healthy trails, and healthy huts in their community is 23 percent, 43 percent, and 25 percent, respectively. Controlling for a series of confounding factors at the community and individual levels, we find that healthy parks and healthy trails are positively correlated with self-reported health, which increases the probability of self-reporting good health by 2.0 percentage points (p < 0.10) and 6.0 percentage points (p < 0.01), respectively. Access to healthy huts is negatively associated with self-reported health, decreasing the probability of self-reporting good health by 5.0 percentage points (p < 0.01). Health literacy plays a role in moderating the effect of health parks, and a positive effect is more likely to be observed among adults with lower health literacy. Health supporting environments may play a role in reducing the likelihood of undiagnosed diseases and changing residents' lifestyles, which promotes the health and well-being of residents, especially among those with inadequate health literacy.