Abstract: Objective To survey the health literacy status and its influence factors of primary students in Guangzhou, and provide theoretical basis for the improvement of health literacy.Methods Cluster sampling method was used to select 3,135 students in three primary schools in Guangzhou in May 2020 and they were surveyed by general information questionnaire and health literacy questionnaire. Binary logistic regression analysis was performed for the influencing factors.Results The awareness rate of health literacy of primary students in Guangzhou was 78.92%. Among them, qualified rate of health knowledge, health skills and health behavior was 81.75%, 70.59% and 51.29%, respectively (P<0.001). Health education course, family/classmates and lectures were the top three channels for students to acquire health knowledge. Binary logistic regression analysis showed that the rate of health literacy of senior students was higher than that of junior students. The better self-rated school achievement, the higher level of health literacy. Students with more access to health literacy had higher level than those with less access (P<0.05).Conclusion Health literacy level of primary students in this study is not high which needs to be improved in the future. Students with better school achievement, senior students and students with more access to health literacy are more likely to have high level of health literacy. The awareness rate of health knowledge is higher than that of health skills and health behaviors. Cooperation among schools,families and hospitals are recommended to provide targeted health education to promote effective transformation of health knowledge into health behavior, thus to improve health literacy of primary students.

Key words: primary student, health literacy, influence factor