Study on the relationship between health literacy and health status among residents in Qingdao
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摘要:
目的 分析青岛市居民健康素养现状及其与慢性病患病、自评健康状况的关系，探讨健康素养对健康状况的影响，为健康教育干预措施和策略的制定提供依据。 方法 采用分层多阶段与人口规模成比例抽样（probability proportionate to size sampling，PPS）方法，2017年于青岛市抽取10个区（市）16 700名15~69岁常住居民进行问卷调查。 结果 青岛市居民总体健康素养水平为15.92%，慢性病患病率为19.31%，自评健康状况好、一般和差的比例分别为81.68%、12.12%和1.71%；有序Logistic分析显示，在调整城乡、性别、年龄、文化程度、收入、职业等因素后，健康素养是人群慢性病患病和自评健康的保护性因素（OR=1.232，P=0.003；OR=1.159，P=0.033），健康素养的三个方面均与人群慢性病患病和自评健康状况有关（均有P<0.05）。 结论 健康素养与居民健康状况呈正相关关系，健康素养水平的提升是提高居民健康状况的重要途径。 -
关键词:
- 健康素养 /
- 健康状况 /
- 有序Logistic回归 /
- 青岛
Abstract:Objective To analyze the status of health literacy and its relationship with chronic diseases and self-reported health among residents in Qingdao, discuss the influence of health literacy on health status and provide the scientific basis for the development of health education strategies and measures. Methods The stratified multistage and probability proportionate to population size sampling (PPS sampling) method was adopted in this investigation. In 2017, a questionnaire survey was conducted among 16 700 permanent residents aged 15-69 from 10 districts in Qingdao. Results The overall level of health literacy status was 15.92%, the prevalence rate of chronic diseases was 19.31%, the self-reported health proportion of good, fair and poor were 81.68%, 12.12% and 1.71% among residents in Qingdao. Logistic regression analysis showed that, after adjusting for urban and rural areas, gender, age, education, income and occupation, health literacy was a protective factor for people with chronic diseases and self-evaluated health(OR=1.232, P=0.003;OR=1.159, P=0.033). Three aspects of health literacy were correlated with chronic diseases and self-reported health among people (all P<0.05). Conclusions Health literacy is positively correlated with the health status of residents. The improvement of health literacy is an important way to enhance the health status of residents. -
Key words:
- Health literacy /
- Health status /
- Ordinal Logistic regression /
- Qingdao
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表 1 不同人口学特征的居民具备健康素养水平分析(%)
Table 1. Health literacy level by residents' characteristics(%)
人口学特征 调查人数 健康素养a 基本知识和理念a 健康生活方式与行为a 健康技能a 城乡 城市 8 507 17.87 37.16 17.99 27.61 农村 4 976 12.58 25.78 13.61 17.83 χ2值 65.581 183.809 43.996 164.868 P值 ＜0.001 ＜0.001 ＜0.001 ＜0.001 性别 男 7 738 16.02 32.41 16.70 23.52 女 5 745 15.77 33.70 15.93 24.65 χ2值 0.160 2.473 1.428 2.297 P值 0.689 0.116 0.232 0.130 年龄(岁) 15~ 2 417 21.80 42.96 22.01 31.90 36~ 7 645 16.19 33.05 16.48 23.75 60~69 3 421 11.14 25.69 12.13 18.97 χ2值b 121.233 188.464 100.320 125.314 P值 ＜0.001 ＜0.001 ＜0.001 ＜0.001 文化程度 小学及以下 3 585 6.47 17.18 7.84 12.05 初中 5 070 15.35 31.79 16.11 22.80 高中/职高/中专 2 786 20.10 40.56 20.06 30.47 大专/本科及以上 2 042 28.21 53.18 26.93 39.13 χ2值b 498.227 846.666 375.400 600.322 P值 ＜0.001 ＜0.001 ＜0.001 ＜0.001 职业c 机关事业单位人员 1 223 26.82 48.32 24.86 35.73 学生 376 21.28 40.96 22.61 30.05 农民 6 440 10.36 23.34 11.68 16.20 工人 2 073 19.01 37.00 20.45 24.70 其他企业人员 1 656 22.89 47.58 21.14 35.75 其他 1 715 17.38 37.38 17.03 31.43 χ2值 343.056 602.070 231.900 492.638 P值 ＜0.001 ＜0.001 ＜0.001 ＜0.001 家庭年收入(万元) ＜1 2 204 6.72 15.83 7.67 11.57 1~ 3 505 12.30 28.27 14.81 19.06 3~ 3 721 17.44 35.98 17.41 26.58 5~ 3 175 21.39 41.51 20.66 31.37 ＞10 878 27.22 50.91 24.49 37.36 χ2值b 333.235 559.268 204.721 422.872 P值 ＜0.001 ＜0.001 ＜0.001 ＜0.001 合计 13 483 15.92 32.96 16.37 24.00 注：a表示构成比; bχ2值为趋势检验的结果; c机关事业单位人员指机关公务员、事业单位人员(包括医生、教师及其他事业单位人员), 其他企业人员指企业单位中除工人以外的其他工作人员。 
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表 2 居民慢性病患病情况、自评健康与健康素养水平的关系(%)
Table 2. The relationship between chronic diseases, self-reported health and the level of health literacy among residents(%)
分组 调查人数 健康素养a 基本知识和理念a 健康生活方式与行为a 健康技能a 慢性病患病情况 不患病 10 880 16.79 34.38 17.41 24.82 患病 2 603 12.26 27.01 12.02 20.59 χ2值b 32.310 51.730 44.469 20.552 P值 ＜0.001 ＜0.001 ＜0.001 ＜0.001 自评健康 好 11 013 16.63 34.39 17.16 25.15 一般 2 240 12.81 26.88 12.90 18.84 差 230 12.18 23.91 12.18 19.13 χ2值b 22.673 56.199 27.681 43.711 P值 ＜0.001 ＜0.001 ＜0.001 ＜0.001 合计 13 483 15.92 32.96 16.37 24.00 注：a表示构成比；bχ2值为趋势检验的结果。
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表 3 居民健康素养对慢性病患病情况影响的Logistic回归分析
Table 3. The impact of the residents' health literacy on chronic disease in the Logistic regression model
变量 单因素分析 多因素分析 P值 OR(95% CI)值 P值 OR(95% CI)值 健康素养(参照：不具备) ＜0.001 1.445(1.272~1.641) 0.003 1.232(1.071~1.416) 三个方面(参照：不具备) 基本知识和理念 ＜0.001 1.416(1.288~1.558) ＜0.001 1.232(1.109~1.368) 健康生活方式与行为 ＜0.001 1.542(1.357~1.753) ＜0.001 1.353(1.178~1.555) 健康技能 ＜0.001 1.273(1.147~1.413) 0.110 1.099(0.979~1.234)
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表 4 居民健康素养对自评健康状况影响的有序Logistic回归分析
Table 4. The impact of the residents' health literacy on the self-reported health in the ordinal Logistic regression model
变量 单因素分析 多因素分析 P值 OR(95% CI)值 P值 OR(95% CI)值 健康素养(参照：不具备) ＜0.001 1.364(1.200~1.551) 0.033 1.159(1.012~1.327) 三个方面(参照：不具备) 基本知识和理念 ＜0.001 1.448(1.314~1.597) ＜0.001 1.266(1.140~1.405) 健康生活方式与行为 ＜0.001 1.408(1.239~1.598) 0.040 1.215(1.063~1.390) 健康技能 ＜0.001 1.443(1.294~1.610) ＜0.001 1.281(1.140~1.439)
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