Objective  To examine the status quo and influencing factors of health literacy among residents in Urumqi municipality of Xinjiang Uygur Autonomous Region.

  Methods  Using multistage random sampling, we conducted a survey among 4 000 permanent residents aged 15 – 69 years in Urumuqi municipality with the national health literacy questionnaire between September and October 2018. Chi-square test was used to analyze disparities in health literacy level and unconditional logistic regression for categorical variables was adopted to explore influencing factors of health literacy.

  Results  Among the 3 719 respondents with valid information, 13.1% were assessed with adequate overall health literacy and the proportions with adequate major health literacy domains were 19.2% for basic knowledge and theory, 16.6% for healthy lifestyles and 25.7% for fundamental skills, with the highest proportion (40.1%) for safety and first aid and the lowest (8.6%) for health information among the 6 health literacy aspects. The proportion of with adequate health literacy was higher among the respondents aged 25 – 34 years (19.6%) and working in public institutions (17.2%) and the health literacy level was positively correlated with education among the respondents (χ² = 238.96, P < 0.05). Logistic regression analysis demonstrated that following respondents were more likely to have a higher health literacy: aged 35 – 44 years (compared to the aged 15 – 24 years: odds ratio OR = 1.82, 95% confidence interval 95% CI: 1.18 – 2.80), with the education of undergraduate and above (OR = 8.75 95% CI: 5.30 – 14.45), and with the occupation of other than worker/ office clerk (OR = 1.58 95% CI: 1.21 – 2.07).

  Conclusion  The health literacy needs to be improved among residents in Urumqi city and age, education, and occupation are main factors influencing health literacy in the residents.