Objective To understand the status of residents' ecological environment and health literacy levels in Gaoyou, China, and analyze their influencing factors so as to provide a scientific basis for monitoring and evaluating ecological environment and health literacy, and determining goals and priorities of literacy improvement.

Methods A questionnaire survey on the ecological environment and health literacy of residents was conducted among residents in Gaoyou from February to March 2021. A total of 265 subjects were selected by the multistage stratified sampling method, and logistic regression was used for multivariate analysis.

Results The overall level of ecological environment and health literacy of Gaoyou residents was 80.75%, with the health literacy levels of basic concepts, basic knowledge and basic skills being 70.94%, 70.57% and 67.55%, respectively. Multivariate logistic regression analysis showed that subjects with primary education had lower levels of the ecological environment and health literacy than those with junior college degree or above odd ratio, OR(95%CI)=4.391(1.262, 15.280), P=0.020. Subjects obtaining related knowledge through three ways OR(95%CI)=4.953(1.304, 18.813), P=0.019 or four ways OR(95%CI)=3.700(1.313, 10.424), P < 0.013 had higher levels of the ecological environment and health literacy than those through one way. There were no significant differences in other factors.

Conclusion The ecological environment and health literacy levels of residents in Gaoyou are generally high. Residents with lower education levels and less ways to obtain environment and health-related knowledge should be focused as key intervention targets, and scientific and effective communication strategies should be formulated.