Abstract: Objective To analyze the change trend of health literacy level of farmers in Shiyan City from 2017 to 2020，provide reference for health literacy intervention. Methods The monitoring data of health literacy of farmers in Shiyan City from 2017 to 2020，were collected to analyze the health literacy level，the absolute growth and average growth rate of farmers' health literacy in four years. Results From 2017 to 2020，the health literacy levels of farmers in Shiyan City were 4.58%，14.37%，16.21% and 17.50%，respectively，with an absolute growth of 12.93% and an average growth rate of 56.38%.The literacy levels of health knowledge，lifestyle and behavior，and health skills showed an upward trend（all P<0.01），with an average annual growth rate of 57.20%，87.17%，26.54%，respectively. Among the six types of health literacy，the levels of scientific health concept，prevention and treatment of infectious diseases，prevention and treatment of chronic diseases，safety and first aid，basic medical care and health information literacy showed an upward trend（all P<0.01），with an average annual growth rate of 30.51%，54.50%，84.04%，26.56%，47.21% and 42.49%，respectively. From 2017 to 2020，the correct rates of six kinds of health literacy questions showed an increasing trend except the correct rate of "correct understanding of liver"（all P<0.01）. Conclusion The health literacy level of farmers in Shiyan City shows a slow rising trend from 2017 to 2020，and it is necessary to carry out health education for the content with low correct rate among the six types of health literacy problems to further improve the health literacy level of farmers.

Key words: Health literacy, Farmers, Change