OBJECTIVES: To assess communicable disease-related health behavior (CDRHB) and the relationship between communicable disease-specific health literacy (CDSHL) and CDRHB in older adults. BACKGROUND: Factors associated with CDRHB in older adults is unclear. METHODS: A cross-sectional survey of 380 Chinese older adults was conducted. A structural equation model (SEM) identified factors associated with CDRHB and their effect magnitude. RESULTS: Mean CDRHB score was 41.92 (± 7.44). Residence type, education, CDSHL, self-efficacy, social support, and internal health locus of control (HLC) were independently associated with CDRHB (p <
0.05). SEM showed CDSHL had the strongest association with CDRHB, followed by education, residence type, social support, internal HLC, and self-efficacy. CONCLUSIONS: Future tailored-intervention research on CDRHB should focus on CDSHL promotion and social support expansion, focused on older adults in rural areas and those with lower education levels.