中国城乡居民健康素养状况及影响因素研究

Study on the health literacy status and its influencing factors of urban and rural residents in China

目的了解我国城乡居民健康素养状况及影响因素,为制定相关的策略和政策提供科学依据。方法采用多阶段分层抽样方法对6省18～69岁居民进行抽样,通过健康素养调查问卷进行现场调查,利用健康素养综合指数进行评价并分析影响因素。结果共调查11759人,回收有效问卷11693份,有效回收率为99.4%。城市居民的知识性、行为性、信念性、功能性健康素养分指数及综合指数分别为5.58±1.12、5.72±2.06、5.29±0.93、5.44±1.04和5.51±0.88,农村居民依次分别为4.42±1.25、4.28±1.92、4.71±1.17、4.56±1.13和4.50±0.99,二者之间差异有统计学意义。不同文化程度的人群中大学及以上学历人群的健康素养分指数和综合指数最高,依次为6.16±0.82、6.47±1.84、5.55±0.74、6.01±0.88和6.05±0.68;文盲半文盲组最低,依次为3.65±0.97、3.90±1.57、4.11±1.14、3.71±0.87和3.81±0.76。在不同年龄组中,18～29岁年龄组的健康素养分指数和综合指数最高,分别为5.34±1.16、5.27±2.06、5.27±0.94、5.32±1.04和5.31±0.90;60～69岁年龄组的健康素养分指数和综合指数最低,依次为4.57±1.40、4.98±2.14、4.78±1.17、4.66±1.22和4.72±1.15。不同性别、文化程度及年龄组人群的健康素养分指数和综合指数具有显著性差异(P<0.05或P<0.01)。有序多分类Logistics回归分析显示,影响城乡居民健康素养主要因素是文化程度和经济收入。结论我国城乡居民人群的健康素养状况差异巨大,其影响因素各有特点,应有针对性制定健康教育与健康促进策略,以提高我国公众健康素养。

Objective To investigate the health literacy status and its influencing factors of urban and rural resi- dents in China, and to provide scientific basis for developing strategies of health literacy. Methods A multi-stage strati- fied sampling method was used to select the sample population in the six provinces of China, about 12 000 adults aged 18 - 69 years old. The health literacy indexes were used to evaluate the health literacy status and analyze its influencing factors. Results The samples were 11 759 persons, the valid questionnaires were 11 693 and the effective recovery rate was 99.4 %. The health literacy indexes of urban residents including knowledge, behavior, attitude, functional and index were 5.58 ± 1.12, 5.72 ±2. 06, 5. 29 ±0. 93, 5.44 ± 1.04 and 5.51±0. 88 respectively, and those of rural residents were 4. 42 ± 1.25, 4. 28±1.92, 4. 71± 1.17, 4. 56± 1.13 and 4. 50 ±0. 99 respectively. Adults who graduated from high school had highest average health literacy indexes which were 6. 16±0. 82, 6. 47± 1.84, 5.55± 0. 74, 6.01 ±0. 88 and 6. 05± 0. 68. Adults with illiterate or semiliterate were the lowest in those groups whose indexes were 3. 65± 0. 97, 3.90 ± 1.57, 4. 11± 1.14, 3.71±0. 87 and 3.81±0. 76. Adults aged 18 to 29 had the highest average health literacy indexes 5.34 ± 1.16, 5. 27±2. 06, 5.27±0.94, 5.32 ± 1.04 and 5.31±0. 90. Adults aged 60 to 69 were the lowest in those groups whose indexes were 4.57± 1.40, 4. 98±2. 14, 4. 78± 1.17, 4. 66±1.22 and 4. 72± 1.15. There were significantly different among the different education and genders. Education and income were found as the main factors of affecting population health literacy （ P 〈 0. 05 or P 〈 0. 01 ） by using Logistic regression analysis. Conclusion There were signifi- cant difference and different characteristics in health literacy between urban and rural residents in China. China should de- velop health education and health promotion strategies on health literacy promotion according to the characteristics of popu- lations.