Study on the trend of health literacy and its influencing factors in Chongqing, 2012-2016
-
摘要:
目的 了解2012-2016年重庆市居民健康素养水平变化趋势，探讨健康素养水平的影响因素，为卫生相关政策的改进提供科学依据。 方法 2012-2016年采用分层多阶段随机抽样方法对重庆市居民进行问卷调查。 结果 2012-2016年重庆市居民健康素养水平分别是4.94%、8.38%、8.71%、10.16%和11.82%；多因素分析显示，女性（OR=1.018，95% CI：1.015~1.021，P < 0.001）、25~岁（OR=1.037，95% CI：1.033~1.041，P < 0.001）、35~岁（OR=1.143，95% CI：1.139~1.148，P < 0.001）、小学（OR=2.065，95% CI：2.044~2.087，P < 0.001）、初中（OR=3.804，95% CI：3.765~3.843，P < 0.001）、高中/职高/中专（OR=6.245，95% CI：6.179~6.311，P < 0.001）、大专/本科及以上（OR=12.305，95% CI：12.173~12.438，P < 0.001）、家庭人均年收入3 000~元（OR=1.570，95% CI：1.560~1.580，P < 0.001）、5 000~元（OR=1.897，95% CI：1.887~1.907，P < 0.001）、10 000~元（OR=1.885，95% CI：1.875~1.896，P < 0.001）及>15 000元（OR=2.097，95% CI：2.086~2.108，P < 0.001）是健康素养的保护因素；农村、45~岁、55~岁及65~岁是健康素养的危险因素（均有P < 0.001）。 结论 2012-2016年重庆市居民健康素养水平呈逐年上升趋势，应针对农村居民、男性和年龄较大者、文化程度较低者和家庭人均年收入较低者进行健康教育工作。 Abstract:Objective To understand the changing trend of health literacy level of residents in Chongqing from 2012 to 2016, and to explore the influencing factors of health literacy level, so as to provide scientific basis for the improvement of health related policies. Methods Stratified multi-stage random sampling was used in the questionnaire survey of residents in Chongqing from 2012 to 2016. Results The health literacy levels of residents in Chongqing City from 2012 to 2016 were 4.94%, 8.38%, 8.71%, 10.16%, and 11.82% respectively. The analysis of multiple factors showed that female (OR=1.018, 95% CI:1.015-1.021, P < 0.001), people under the survey aged between 25 and 34 (OR=1.037, 95% CI:1.033-1.041, P < 0.001), people under the survey aged between 34 and 44 (OR=1.143, 95% CI:1.139-1.148, P < 0.001), primary school(OR=2.065, 95% CI:2.044-2.087, P < 0.001), junior middle school (OR=3.804, 95% CI:3.765-3.843, P < 0.001), senior high school, vocational high school and technical secondary school (OR=6.245, 95% CI:6.179-6.311, P < 0.001), junior college, undergraduate degree and degrees above those (OR=12.305, 95% CI:12.173-12.438, P < 0.001), the annual average household income between 3 000 and 5 000 yuan (OR=1.570, 95% CI:1.560-1.580, P < 0.001), the annual average household income between 5 000 and 10 000 yuan (OR=1.897, 95% CI:1.887-1.907, P < 0.001), the annual average household income between 10 000 and 15 000 yuan(OR=1.885, 95% CI:1.875-1.896, P < 0.001) and the annual average household income more than 15 000 yuan(OR=2.097, 95% CI:2.086-2.108, P < 0.001) were protective factors for health literacy; rural areas, the people under this survey aged between 45 and 54 the people under this survey aged between 55 and 64 and the people under this survey aged between 65 and 69 were risk factors of the health literacy. Conclusions From 2012 to 2016, the health literacy level of the residents in Chongqing City has been increasing year after year, and health education should be conducted for rural residents. The health education should be concentrated on people in rural areas, male, the elderly, people with lower education level, and people with lower average annual household income. -
Key words:
- Health literacy /
- Trend of health literacy /
- Health education /
- Influencing factors
-
表 1 2012-2016年重庆市居民社会学与人口学特征
[n (%)] Table 1. The demographic and sociological characteristics of residents from 2012 to 2016, in Chongqing
[n (%)] 人口学特征 2012年 2013年 2014年 2015年 2016年 城乡 城镇 782(57.16) 1 078(49.91) 883(41.63) 952(49.64) 2 482(30.22) 农村 586(42.84) 1 082(50.09) 1 238(58.37) 966(50.36) 5 732(69.78) 性别 男 713(52.12) 1 044(48.33) 1 098(51.77) 993(51.77) 4 147(50.49) 女 655(47.88) 1 116(51.67) 1 023(48.23) 925(48.23) 4 067(49.51) 年龄(岁) 15~ 97(7.09) 204(9.44) 168(7.92) 150(7.82) 438(5.33) 25~ 156(11.40) 321(14.86) 286(13.48) 256(13.35) 828(10.08) 35~ 307(22.44) 508(23.52) 451(21.26) 377(19.66) 1 442(17.56) 45~ 299(21.86) 456(21.11) 512(24.14) 490(25.54) 2 424(29.51) 55~ 356(26.02) 505(23.38) 481(22.68) 419(21.85) 1 990(24.23) ≥65 153(11.18) 166(7.69) 223(10.51) 226(11.78) 1 092(13.29) 文化程度 不识字或
识字很少203(14.84) 236(10.93) 243(11.46) 259(13.50) 1 232(15.00) 小学 423(30.92) 636(29.44) 722(34.04) 618(32.22) 2 896(35.26) 初中 513(37.50) 654(30.28) 614(28.95) 628(32.75) 2 446(29.78) 高中/职高
/中专154(11.26) 335(15.51) 303(14.29) 271(14.13) 1 022(12.44) 大专/本科及
以上75(5.48) 299(13.84) 239(11.27) 142(7.40) 618(7.52) 家庭人均年收
入(元)< 3 000 400(29.54) 415(19.51) 404(19.05) 425(22.16) 1 823(22.19) 3 000~ 158(11.67) 196(9.21) 182(8.58) 223(11.63) 979(11.92) 5 000~ 320(23.63) 539(25.34) 552(26.03) 479(24.97) 2 176(26.49) 10 000~ 279(20.61) 477(22.43) 407(19.19) 294(15.33) 1 347(16.40) >15 000 197(14.55) 500(23.51) 576(27.16) 497(25.91) 1 889(23.00) 
下载: 导出CSV
表 2 2012-2016年重庆市居民三个方面健康素养水平
(%) Table 2. Health literacy level of Chongqing residents in three aspects from 2012 to 2016
(%) 素养水平 2012
年2013
年2014
年2015
年2016
年χ2值 P值 基本知识和理念 9.51 14.96 16.81 22.66 24.79 137.603 < 0.001 健康生活方式与行为 5.16 12.40 10.17 8.94 12.56 9.141 0.002 基本技能 5.99 8.31 12.66 14.77 11.47 18.028 < 0.001 健康素养 4.94 8.38 8.71 10.16 11.82 32.432 < 0.001
下载: 导出CSV
表 3 2012-2016年重庆市居民六类健康问题健康素养水平
(%) Table 3. Health literacy level of six types of health problems among Chongqing residents from 2012 to 2016
(%) 素养水平 2012
年2013
年2014
年2015
年2016
年χ2值 P值 科学健康观 20.76 26.61 22.15 24.27 28.54 9.541 0.002 传染病防治 10.79 19.30 16.33 16.46 27.93 165.950 < 0.001 慢性病防治 4.39 12.39 7.23 10.54 7.09 27.233 < 0.001 安全与急救 22.26 37.32 36.95 41.73 47.12 163.494 < 0.001 基本医疗 5.55 8.18 14.73 17.17 10.59 6.278 0.012 健康信息 9.97 14.94 15.02 16.48 22.49 114.107 < 0.001
下载: 导出CSV
表 4 健康素养与三个方面健康素养相关系数表
Table 4. The table of Correlation coefficient between health literacy and three aspects of health literacy
健康素养 基本知识
和理念健康生活方式
与行为基本技能 健康素养 1.000 基本知识和理念 0.613a 1.000 健康生活方式与行为 0.622a 0.432a 1.000 基本技能 0.584a 0.451a 0.346a 1.000 注：a表示P < 0.05。
下载: 导出CSV
表 5 健康素养水平影响因素的多因素Logistic回归分析
Table 5. Logistic regression model for identifying factors that affect health literacy
组别 β值 标准误 OR(95% CI)值 P值 城乡 城镇 1.000 农村 -0.430 0.002 0.651(0.649~0.653) < 0.001 性别 男 1.000 女 0.018 0.001 1.018(1.015~1.021) < 0.001 年龄(岁) 15~ 1.000 25~ 0.036 0.002 1.037(1.033~1.041) < 0.001 35~ 0.134 0.002 1.143(1.139~1.148) < 0.001 45~ -0.153 0.002 0.858(0.854~0.862) < 0.001 55~ -0.224 0.003 0.800(0.795~0.804) < 0.001 ≥65 -0.034 0.004 0.966(0.958~0.975) < 0.001 文化程度 不识字或识字很少 1.000 小学 0.725 0.005 2.065(2.044~2.087) < 0.001 初中 1.336 0.005 3.804(3.765~3.843) < 0.001 高中/职高/中专 1.832 0.005 6.245(6.179~6.311) < 0.001 大专/本科及以上 2.510 0.005 12.305(12.173~12.438) < 0.001 家庭人均年收入(元) < 3 000 1.000 3 000~ 0.451 0.003 1.570(1.560~1.580) < 0.001 5 000~ 0.640 0.003 1.897(1.887~1.907) < 0.001 10 000~ 0.634 0.003 1.885(1.875~1.896) < 0.001 >15 000 0.741 0.003 2.097(2.086~2.108) < 0.001
下载: 导出CSV
-
[1] Bodie GD, Dutta MJ. Understanding health literacy for strategic health marketing: eHealth literacy, health disparities, and the digital divide [J]. Health Mark Q, 2008, 25(1-2):175-203. DOI: 10.1080/07359680802126301. [2] 中华人民共和国国家卫生健康委员会.中共中央国务院印发《"健康中国2030"规划纲要》[EB/OL]. (2016-10-25)[2019-12-20]. http://www.nhc.gov.cn/guihuaxxs/s3586s/201610/21d120c917284007ad9c7aa8e9634bb4. [3] 中华人民共和国国家卫生健康委员会.卫生部办公厅关于印发《中国公民健康素养促进行动工作方案(2008-2010年)》的通知[ EB/OL]. (2008-09-03)[2019-12-20]. http://www.nhc.gov.cn/bgt/pw10810/200809/6adc0a659c5f43deb8058a9f4da86b5f.shtml. [4] 李英华, 聂雪琼. 2008年与2012年全国健康素养调查方案对比分析[J].中国健康教育, 2014, 30(2):176-177. DOI: 10.16168/j.cnki.issn.1002-9982.2014.02.020.Li YH, Nie XQ. Contrast analysis of 2008 and 2012 Chinese health literacy survey scheme [J].Chin J Health Edu, 2014, 30(2):176-177. DOI: 10.16168/j.cnki.issn.1002-9982.2014.02.020. [5] 聂雪琼, 李英华, 李莉. 2012年中国居民健康素养监测数据统计分析方法[J].中国健康教育, 2014, 30(2):178-181. DOI: 10.16168/j.cnki.issn.1002-9982.2014.02.021.Nie XQ, Li YH, Li L. Statistic analysis of 2012 Chinese residents health literacy monitoring [J]. Chin J Health Edu, 2014, 30(2):178-181. DOI: 10.16168/j.cnki.issn.1002-9982.2014.02.021. [6] Ishikawa H, Nomura K, Sato M, et al. Developing a measure of communicative and critical health literacy: a pilot study of Japanese office workers [J]. Health Promot Int, 2008, 23(3):269-274. DOI: 10.1093/heapro/dan017. [7] Aaby A, Friis K, Christensen B, et al. Health literacy is associated with health behaviour and self-reported health: A large population-based study in individuals with cardiovascular disease [J]. Eur J PrevCardiol, 2017, 24(17):1880-1888.DOI: 10.1177/2047487317729538. [8] Karina F, Donslund VB, Simmons RK, et al. The Relationship between health literacy and health behaviour in people with diabetes: A Danish population-based study [J]. J Diabetes Res, 2016:7823130. DOI: 10.1155/2016/7823130. [9] 张人华, 李亚非, 何琳, 等. 2017年贵州省少数民族居民健康素养现状分析[J].中国健康教育, 2019, 35(1):17-20, 28. DOI: 10.16168/j.cnki.issn.1002-9982.2019.01.004.Zhang RH, Li Y, He L, et al. Analysis on health literacy of ethnic minority residents in Guizhou Province in 2017 [J]. Chin J Health Edu, 2019, 35(1):17-20, 28. DOI: 10.16168/j.cnki.issn.1002-9982.2019.01.004. [10] 唐驰, 何秋平, 郭亮永, 等.广西南宁市15~69岁居民健康素养现况调查及影响因素分析[J].中国健康教育, 2019, 35(2):109-115. DOI: 10.16168/j.cnki.issn.1002-9982.2019.02.003.TangC, He QP, Guo LY, et al. Investigation on health literacy of residents aged 15-69 in Nanning City, Guangxi and analysis of influencing factors [J]. Chine J Health Edu, 2019, 35(2):109-115. DOI; 10.16168/j.cnki.issn.1002-9982.2019.02.003. doi: 10.16168/j.cnki.issn.1002-9982.2019.02.003 -
