Objective  To examine the current status of health literacy and quality of life and to explore the relationship between health literacy and quality of life among college students in Nanjing city.

  Methods  Using stratified cluster random sampling, the Health Literacy Questionnaire developed by Chinese Center for Health Education and the European Quality of Life-5 Dimensions (EQ-5D), we conducted a survey among 5 706 freshmen and junior students in 3 universities in Nanjing city of Jiangsu province. SPSS software was used in statistical descriptions, univariate analysis and multivariate analysis.

  Results  Of the students surveyed, 38.1% were assessed with adequate health literacy and 65.2%, 42.6%, and 46.9% with basic health knowledge, health lifestyle, and health skills, respectively. The he mean EQ-5D score was 0.92 ± 0.11 and the mean self-rated health score (visual analogue scale VAS) was 85.13 ± 12.49 for all the students. Univariate analysis indicated that the female students, junior students, and the students majoring in medicine and with higher maternal education had a higher health literacy (P < 0.05 for all); while the male students, freshmen, and the students majoring in art and science had a high quality of life (all P < 0.05). Multivariate analysis revealed following significant impact factors of health literacy: majoring (medicine vs. non-medicine: odds ratio OR = 2.316, 95% confidence inter val 95% CI: 1.837 – 2.920), grade (junior vs. freshman: OR = 1.138, 95% CI: 1.019 – 1.271), university (OR = 1.253, 95% CI: 1.109 – 1.415), maternal education (with formal education vs. iliterate or semiliterate: OR = 1.124, 95% CI: 1.069 – 1.183), academic record (poor vs. excellent: OR = 0.898, 95% CI: 0.849 – 0.950), and monthly personal living expenses (≥ 500 yuan vs. < 500 yuan: OR = 0.947, 95% CI: 0.902 – 0.995). The correlation coefficient for the correlation between health literacy and quality of life was 0.042 for all the students (0.040 and 0.046 for medical and non-medical students).

  Conclusion  The college students in Nanjing city have a high level of health literacy but the health literacy score is not strongly associated with health-related quality of life among the students.