我国城乡居民健康素养影响因素分析

Analysis of health literacy influencing factors among urban and rural residents in China

目的分析我国城乡居民健康素养的主要影响因素,为制定相关政策提供依据。方法采取多阶段分层随机抽样方法,对全国31个省(自治区、直辖市)及新疆生产建设兵团79 542名15～69岁常住人口开展问卷调查。结果中国居民具备健康素养的比例是6.48%,城市为9.94%,农村为3.43%。单因素和多因素分析均发现,文化程度、地域、民族、婚姻、家庭规模和收入是城乡居民健康素养共同影响因素。文化程度是最重要的影响因素,文化程度越高,具备健康素养的人口比例越高(城市OR=1.854,农村OR=2.972)。与东部地区比较,中部地区居民健康素养水平较高(城市OR=1.063,农村OR=1.255),西部较低(城市OR=0.86,农村OR=0.72)。少数民族低于汉族;已婚者略高于未婚者;家庭规模越大,家庭收入越低,家庭成员的健康素养水平越低。多因素分析发现,城市居民年龄越大健康素养越高(OR=1.005),农村居民与此相反,年龄越大健康素养越低(OR=0.985);城市男性健康素养水平高于女性(OR=1.069),但农村不同性别之间差异无统计学意义。结论城乡居民健康素养影响因素略有差异。文化程度是居民健康素养最重要的影响因素,地域、民族、婚姻、家庭规模和收入不同程度地影响城乡居民健康素养。

Objective To investigate the health literacy level and its influencing factors among urban and rural residents in China, and provide scientific supports for developing intervention strategies of health literacy. Methods A multistage stratified random sampling method was applied to investigate the urban and rural permanent residents aged 15 - 69 years in all provinces, autonomous regions, and municipalities of China's Mainland. Totally 79 542 adults were inter- viewed in 2008. Results The proportion of the respondents who had adequate health literacy （PAHL） among the Chinese residents was 6. 48% totally, 9.94% in urban and 3.43% in rural residents, respectively. Univariate analysis and logistic regression analysis showed that education, region, nationality, marriage status, family size and gender were influencing fac- tors related PAHL level ： the higher educational level the respondents had, the higher the proportion of PAHL was （ OR = 1. 854 in urban and OR = 2. 972 in rural areas） ; compared with the East China, the PAHL in the Centtal China was higher （ OR = 1. 063 in urban and OR = 1. 255 in rural areas） and lower in the West （ OR =0. 86 in urban and OR = 0. 72 in ru- ral areas）. PAHL in the Han nationality, married people, the people in small size of family and higher family income was higher than the others. Logistic regression analysis found that PAHL were higher among elder people in urban areas （ OR = 1. 005 ） while lower in rural areas （ OR = 0. 985 ）, PAHL was higher in men in urban areas （ OR = 1. 069） while no statis- tic significance in the regression equation. Conclusion Health literacy influencing factors differ little in urban and rural residents. Education was the most important factors and region, nationality, marriage status, family size and economics were important and general influencing factors related health literacy among urban and rural residents in China.