Objective  To explore the situation and associated factors of health literacy among residents in Yunnan province and to provide evidences for improving health literacy in the population.

  Methods  We recruited 32 352 residents aged 15 – 69 years in 312 rural towns/urban communities of Yunnan province using stratified multistage sampling and conducted a survey with national health literacy questionnaire during July – September 2018.

  Results  Of all the respondents, only 14.03% (95% confidence interval 95% CI: 12.33% – 15.91%) were assessed with adequate overall health literacy and the proportions of the respondents with adequate health literacy domains were 11.38% for fundamental skills, 17.72% for health information, 16.95% for infectious diseases prevention and treatment, and 16.12% for basic medical care, all of which were at a relatively low level. Multivariate logistic regression analyses revealed that the respondents with following characteristics were more likely to have a low health literacy: ethnic minorities (compared to Han people: odds ratio OR = 0.730, 95% confidence interval 95% CI: 0.587 – 0.907), lower education compared to the education of college or above (illiterate/semiliterate: OR = 0.054 95% CI: 0.036 – 0.081, primary school: OR = 0.125 95% CI: 0.093 – 0.170, junior high school: OR = 0.329 95% CI: 0.263 – 0.411, senior high school/vocational high school/technical secondary school: OR = 0.704 95% CI: 0.583 – 0.851), and with lower annual household income (< 8 000 vs. ≥ 12 000 yuan RMB per capita, P < 0.05); while, the respondents at younger age (aged 25 – 34 vs. 65 – 69 years: 1.393 95% CI: 1.009 – 1.922) and being medical workers (compared to other occupations: 2.005 95% CI: 1.379 – 2.915) were more likely to have a higher health literacy.

  Conclusion  Health literacy is at a low level among adult urban and rural residents and the residents being ethnic minorities, at middle and elder ages, with low education, and having low household income are key populations for education on health literacy in Yunnan province.