Health Literacy and Health-Related Habits among Conscripts in the Norwegian Armed Forces-A Cross-Sectional Survey.

Introduction: Although health information is widely available to the Norwegian population a lack of health literacy is still common and considered a public health challenge. However, there is limited information on the health literacy of the adolescent population in Norway. The purpose of this pilot study was to assess health literacy and self-reported health habits among soldiers in basic military training, both in field, camp, and home settings. Furthermore, we aimed to investigate which health habits characterize soldiers with inadequate health literacy.

Methods: An electronic questionnaire was sent out to conscripts who completed first-time military service in 2022 and was answered by 2,225 conscripts. Descriptive statistics were performed using cross-tabulations, correlations, and chi-squared tests. The survey is part of an internal quality study of the Norwegian Armed Forces routines. It is approved by the Norwegian Armed Forces joint medical services.

Results: In the study population, 43% scored inadequate health literacy on the European Health Literacy Survey Questionnaire-Q12 (HLS-Q12), and 57% scored adequate health literacy. We found a significant difference between those having inadequate and adequate HLS-Q12 scores in categories of self-rated health habits of oral health and diet with lower scores in the inadequate score group. The use of tobacco during field exercise in camp and at home was higher in the group of conscripts with adequate health literacy scores. The conscripts generally reported a lower standard of health habits during field exercises with significantly less brushing and flossing, higher use of tobacco products and higher consumption of energy drinks and sugary snacks compared to reported habits in camp and at home.

Conclusion: The results from our study suggest that the conscripts in the Norwegian Armed Forces have a lower health literacy than the general population, and this is reflected in reported higher frequency of unhealthy habits in service settings than at home. The Armed Forces have an opportunity to take responsibility to optimize the health skills of their soldiers and to encourage them to make informed decisions about their own health. Improved adaptation to the national recommendations regarding nutrition, tobacco use, and oral health are areas having the potential to greatly improve the overall health habits of conscripts.