Objective  To examine the level of basic health literacy among female residents in Nanjing city and to provide a basis for making programs of intervention on health literacy.

  Methods  With stratified multistage random cluster sampling, 4 694 female urban and rural residents aged 15 – 69 years were selected and surveyed with the Chinese Residents Health Literacy Questionnaire from October to December 2016.

  Results  The ratio of participants with basic health literacy was 19.5%. The health literacy score of the urban participants was higher than that of the rural participants. The participants' health literacy score declined with the increment of their age; the score was the highest (46.08 ± 10.75) for the participants aged 25 – 34 years and the lowest (37.61 ± 11.91) for those aged 65 – 69 years. The health literacy score of the participants was positively correlated with their education level, with the highest score (47.29 ± 10.54) for the participants with college or undergraduate education and the lowest (34.50 ± 12.19) for those being illiterate or semiliterate. The score of the participants engaged in medical work was higher than that of those engaged in other occupations; while the score of the participants with chronic diseases was lower than that of healthy participants. The score was correlated positively with the participant's family income. Univariate analysis demonstrated that the health literacy score was significantly influenced by residential region, age, education, whether being a medical worker, whether with chronic disease, and family economy condition among the participants (P < 0.05 for all). Multivariate linear regression analysis revealed that education (β = 0.26), family income (β = 0.14), residential region (β = – 0.08), age (β = – 0.07), and whether being engaged in medical work (β = 0.05) were significant factors affecting health literacy score among the participants (R² = 0.19, P < 0.01）and education was the strongest predicator of the healthy literacy score.

  Conclusion  Health literacy needs to be improved among female residents in Nanjing city.