The Effects of Health Literacy, Social Support, and Health-Promoting Behaviors on Metabolic Syndrome Among Middle-Aged and Older Women Living in Rural Areas of Republic of Korea

Abstract

Highlights: What are the main findings? Obesity, menopausal status, perceived health, health literacy, and health-promoting behaviors are significant predictors of metabolic syndrome among middle-aged and older women in rural Korea. Higher levels of health literacy and engagement in health-promoting behaviors are associated with a lower risk of metabolic syndrome. What are the implications of the main findings? Enhancing health literacy and fostering proactive health responsibility behaviors can reduce metabolic syndrome among rural women. Community-based tailored health education and health literacy programs are es-sential for improving health equity and preventing metabolic disorders among rural women. Background/Objectives: This study examined how health literacy, social support, and health-promoting behaviors influence the prevalence of metabolic syndrome among middle-aged and older women living in rural Republic of Korea. Methods: The participants were 300 women residing in three rural regions. Data were collected from 1 August to 15 September 2025, in cooperation with the Lifestyle Improvement Association. Results: Descriptive and multiple regression analyses were conducted using the collected data. The prevalence of metabolic syndrome was 46.3%, and 36.7% of the participants had one or two risk factors. Factors that significantly influenced metabolic syndrome included obesity (β = 0.36, p < 0.001), health literacy (β = −0.25, p = 0.015), health responsibility (β = 0.25, p < 0.001), subjective health status (β = −0.25, p < 0.001), and menopause (β = 0.16, p = 0.005), which explained 36.3% of the variance (F = 8.59, p < 0.001). Conclusions: Enhancing health literacy and promoting a stronger sense of health responsibility may help reduce the prevalence of metabolic syndrome among middle-aged and older women in rural Republic of Korea.