Objective  To examine the status of health literacy among farmers in Gansu province and to provide references for health education and promotion in the population.

  Methods  Using stratified multistage random sampling, we conducted a survey among 16 687 farmers 15 – 69 years recruited in rural regions across Gansu province during October – December, 2018. Information on health literacy of the farmers were collected with the National Health Literacy Surveillance Questionnaire developed by National Health Commission.

  Results  Among the 16 349 farmers with valid response, only 9.7% (1 587) were assessed with adequate health literacy and the proportion (number) of the farmers with adequate health literacy domains were 18.9% (3 019) for basic health knowledge and theory, 12.4% (1 959) for healthy lifestyle and behavior, and 11.9% (1 905) for fundamental skills; the proportions (number) of the farmers with adequate health literacy of other 6 indicators were 31.7% (5 149) for scientific health concept, 17.0% (2 579) for infectious disease prevention and treatment, 15.1% (2 499) for chronic disease prevention and treatment, 29.6% (4 853) for safety and first aid, 15.8% (2 492) for basic medical care, and 16.4% (2 677) for health information, respectively.

  Conclusion  The health literacy is at a low level among farmers in Gansu province, especially for the health literacy of fundamental skills and chronic disease prevention and treatment, suggesting that targeted education on health literacy should be promoted in the population.