Adolescent health literacy: sociodemographic determinants and its relationship with substance use avoidance.

This article examines the sociodemographic determinants of health literacy (HL)—defined by its functional, interactive, and critical components—and its role in substance use avoidance among U.S. adolescents. Data from 675 adolescents showed that girls, Hispanic/Latine youth, those with high English proficiency, food security, private communication with healthcare providers, and no impaired decision-making had higher HL levels. Higher functional, interactive, and composite HL were associated with greater odds of avoiding substance use, particularly among younger adolescents, indicating HL’s potential as a protective factor against early substance use initiation. The study highlights the need for targeted HL interventions, especially for boys, adolescents with impaired decision-making, and those with lower English proficiency, to delay substance use onset and improve health outcomes.