Objective  To compare health literacy among residents in Wuhan city in 2016 and 2018 for providing evidences to the development of relevant health policies and interventions.

  Methods  Using the National Residents' Health Literacy Monitoring Questionnaire developed by the China Health Education Center, we conducted cell phone- or computer-aid face-to-face survey among 4 500 and 5 300 permanent residents selected with multistage random sampling in Wuhan city, Hubei province in 2016 and 2018, respectively.

  Results  The proportion of the residents with overall health literacy increased significantly from 11.79% in 2016 to 19.29% in 2018 (χ² = 97.063, P < 0.001) and the proportions the residents with health literacy dimensions increased from 22.88% to 33.95% for basic knowledge and concepts, 9.92% to 17.29% for healthy lifestyle and behavior, and 14.74% to 33.20% for basic skills in the three year period, respectively. In 2016, the proportions of the residents with health literacy on the six public health problems in descendant order were 44.42% for safety and first aid, 33.73% for scientific health concept, 19.74% for health information, 16.73% for infectious disease prevention and treatment, 12.75% for basic medical care, and 11.48% for chronic disease prevention and treatment; whereas, the proportions were 57.79% for safety and first aid, 52.81% for scientific health concept, 40.96% for health information, 27.84% for basic medical care, 26.05% for infectious disease prevention and treatment, and 18.98% for chronic disease prevention in 2018, with significant difference compared to those in 2016. However, for the residents surveyed in 2018, the proportion with health literacy on chronic disease prevention, infectious disease prevention and basic medical care were still low and less than 50% of the residents answered correctly to the questions on benefits of eating soy products such as tofu and soy milk, right ways of dealing with coughing and sneezing, and medical description of liver.

  Conclusion  Health literacy was improved in 2018 compared to that in 2016 but health lifestyle and behaviors and health literacy on infectious disease prevention, chronic disease prevention and basic medical care were still at a low level among the residents in Wuhan city. The results suggest that targeted health education should be promoted in the population.