Is health literacy associated with greater medical care trust?

OBJECTIVE: To examine the relationship between health literacy and trust in physicians and in the healthcare system. DESIGN: A cross-sectional survey of a nationally representative sample of adults. SETTING: Taiwan. PARTICIPANTS: Non-institutionalized adults (N = 2199). MAIN MEASURES: Trust in physicians was a composite measure assessing respondents' general trust in physicians and their perceptions of their physician's communication, medical skills, beneficence, honesty, confidentiality, respect and fairness. Trust in the healthcare system was a single-item measure. Health literacy was measured by four items. RESULTS: Respondents with higher health literacy had, overall, higher levels of trust in physicians (P<0.001) and in the healthcare system (P = 0.04). Health literacy remained significantly and positively associated with trust in physicians (P<0.001) and in the healthcare system (P = 0.001) after adjusting for respondents' sociodemographic characteristics. CONCLUSIONS: Our findings demonstrate that health literacy is positively associated with trust. Actionable plans targeting health literacy at the national and local levels to establish a health literate care environment may contribute to enhancing trust in physicians and the healthcare system.