Relationship between digital health literacy and self-assessment of health among older adults in Xuzhou City: based on the mediating effect of health self-management

Background With the global rise in aging populations and the proliferation of digital technologies, digital health literacy has emerged as a critical determinant of older adults’ ability to access health information and enhance their health outcomes. This study investigates the complex interplay and mechanisms linking digital health literacy, health self-management, and self-assessed physical health among older adults in Xuzhou, China. Methods In November 2024, a questionnaire-based survey was conducted among adults aged 60 and older in urban communities of Xuzhou City, Jiangsu Province, China. The questionnaire assessed general demographic characteristics, self-assessed physical health, the Chinese version of the Digital Health Literacy Scale, and the Health Self-Management Scale. A total of 1,005 participants were included, comprising 47% males and 53% females, with a mean age of 67.6 years. Data were analyzed using SPSS 23 software. Results The mean scores for self-assessed physical health, digital health literacy, and health self-management were 3.41 ± 0.83, 24.75 ± 11.74, and 159.72 ± 21.24, respectively. Statistically significant differences were observed in these scores across age groups, marital status, pre-retirement occupation, number of medications, living arrangement, monthly disposable income, and daily internet use (all p 0.05). Digital health literacy, health self-management, and self-assessed physical health were significantly positively correlated (all p 0.01). Digital health literacy positively predicted self-assessed physical health ( β = 0.007, p = 0.041). Health self-management fully mediated the relationship between digital health literacy and self-assessed physical health, with an indirect effect of 0.005 (95% Bootstrap confidence interval 0.003–0.007), accounting for 71.4% of the total effect. Conclusion The findings indicate that digital health literacy positively influences health self-management among older adults. Moreover, through the mediating role of health self-management, digital health literacy contributes to improvements in health behaviors and overall health status among older adults.