Objective  To investigate the level and influencing factors of health literary about chronic disease among permanent residents in Nanjing municipality and to provide evidences for developing specific strategies and approaches for health literary promotion in the population.

  Methods  Using stratified and multistage sampling and probability proportionate to size sampling, we conducted a household survey among 9 234 permanent residents at ages of 15 – 69 years in 12 administrative districts of Nanjing city from October through December, 2016. The Chinese Residents Health Literacy Questionnaire previously used in a national survey was adopted in the study.

  Results  The response rate of the survey was 99.3%. Of the 9 168 participants completing the survey, only 10.9% (95% confidence interval 95% CI = 8.8% – 13.4%) reported adequate health literacy about chronic disease, which was lower than national average level (11.5%) of Chinese residents. Multivariate logistic regression analysis demonstrated that the participants being white-collar workers (versus blue-collar workers: odds ratio OR = 1.35, 95% CI: 1.04 – 1.75) and those with a monthly household income per capita of 1 400 – 2 800 or more than 2 800 yuan RMB (versus < 1 400 yuan: OR = 1.42, 95% CI: 1.03 – 1.95; OR = 1.74, 95% CI: 1.04 – 2.92) were more likely to have a higher health literacy about chronic disease.

  Conclusion  The health literacy about chronic disease was relatively low among adult residents in Nanjing city, suggesting that relevant interventions should be promoted in the population, especially in blue-collar workers or the residents with lower household income.