Objective To understand the ecological environment and health literacy levels of residents in Zhangye, analyze the influencing factors, and provide scientific basis for relevant departments to develop targeted literacy enhancement strategies.

Methods In July and August 2024, a questionnaire survey was conducted using a multistage stratified sampling method to investigate the ecological environment and health literacy levels among residents of different residential areas, genders, age groups, ethnicities, educational backgrounds, and occupations. SPSS 24.0 was used to conduct chi-square test and binary multivariate Logistic regression to analyze the attainment of ecological environment and health literacy and influencing factors across different demographic groups.

Results The overall ecological environment and health literacy level among residents of Zhangye in 2024 was 18.46%, with the highest level of 26.46% for basic skills literacy and the lowest level of 16.23% for basic knowledge literacy. The literacy level of urban residents was significantly higher than that of rural residents. Male residents showed higher overall literacy and basic knowledge literacy compared with female residents. The literacy level tended to decrease with age. Education and occupation significantly influenced literacy levels. Groups with higher education, as well as cadres, civil servants, and students demonstrated high literacy levels. In addition, residents had significant shortcomings in their knowledge of environmental pollution reporting, PM_2.5 pollution-related diseases, and the negative impacts of global warming.

Conclusion The overall ecological environment and health literacy level of residents in Zhangye is relatively low. In the future, we should focus on rural areas, ethnic minority areas, elderly populations, low-education groups, and farmers to improve their literacy levels through differentiated strategies. Regular literacy monitoring should be carried out to provide a scientific basis for improving the ecological environment and health literacy of target residents, thereby promoting the overall improvement of their awareness of health and environmental protection.