Objective  To explore the status and influencing factors of health literacy among Tibet residents and to provide references for determining priorities and making health policies by governmental agencies at different administration levels.

  Methods  Using stratified multistage cluster sampling and proportional to population size sampling, we conducted a household survey among 1 739 permanent residents aged 15 – 69 years in Tibet Autonomous Region between August and December 2015. The National Questionnaire of Health Literacy for Residents was adopted in the survey.

  Results  Among the participants, the level of overall health literacy was 0.17%; the health literacy levels were 1.55% for basic health knowledge and ideas, 0.29% for healthy lifestyle and behavior, and 1.04% for health skills; and the levels of health literacy about 6 categories of health problems were 8.57% for safety and first aid, 4.72% for infectious disease prevention and control, 4.03% for scientific health concept, 3.39% for basic medical treatment, 3.22% for health information, and 0.35% for chronic disease prevention and treatment, respectively. The health literacy score for all the participants was 21.76 ± 9.66. There were no gender and between ethnic group differences in the score (both P > 0.05); whereas, the score of urban participants was significantly higher than that of the rural participants (P < 0.05) and the score increased with educational level significantly (P < 0.001). The participants aged 60 years and elder, with 7 or more family members, being a farmer, and having the annual family income of less than 10 000 RMB Yuan showed significantly lower health literacy scores compared to other participants (P < 0.05 for all).

  Conclusion  Health literacy level of Tibet residents in 2015 was low and the level differed by demographic factors. The study results suggest that health education and promotion should be enhanced among Tibet residents.