2013年江苏省淮安市城区常住居民健康素养现状分析

Analysis of health literacy of residents in urban district of Huaian in 2013, Jiangsu Province

目的通过2013年健康素养现状调查，了解淮安市15～69岁城区常住居民健康素养及其3个维度素养水平分布状况，并探索其影响因素，为制定健康教育策略和措施提供依据。方法采用横断面调查方法，分层多阶段整群随机抽样，于2013年10到12月对淮安市清河、清浦、淮安、淮阴等4个区15～69岁常住居民进行问卷调查，调查内容包括调查对象的一般情况（年龄、性别、职业等）和健康素养的3个维度内容（基本知识和理念、健康生活方式和行为、基本技能）。对健康素养水平影响因素进行χ2检验和logistic回归分析。结果2316名15～69岁城区常住居民具备健康素养人数为401人，健康素养水平为17．3％。基本知识和理念、健康生活方式和行为、基本技能素养水平分别为28．4％、11．6％和19．4％。单因素分析显示，城区常住居民健康素养及其3个维度素养水平随着文化程度提高而升高、家庭人均年收入（元）〉10000高于410000，不同年龄组、不同职业人群健康素养水平差异均有统计学意义（P〈0．05），此外，基本技能素养水平男性高于女性（P〈0．05）；多因素logistic回归分析显示，文化程度对健康素养影响的OR（95％CI）值为1．473（1．337～1．623）、对基本知识和理念素养影响的OR（95％CI）值为1．399（1．289～1．520）、对健康生活方式和行为素养影响的OR（95％CI）值为1．556（1．386～1．746）、对基本技能素养影响的OR（95％CI）值为1．400（1．275～1．538）；相对于农民，企业工人、脑力工作者对健康素养影响的OR（95％CI）值分别为1．559（1．095～2．219）和2．333（1．468～3．706）、对基本知识和理念素养影响的OR（95％CI）值分别为1．390（1．063～1．819）和1．778（1．204～2．625）、对基本技能素养影响的OR（95％CI）值分别为1．721（1．235～2．397）和2．151（1．375～3．365），相对于农民，脑力工作者对健康生活方式和行为素养影响的OR（95％CI）值为1．876（1．093～3．220），均是相关健康素养的正相关因素。结论淮安市15～69岁城区常住居民健康素养水平为17．3％，水平较低，应继续加强健康素养干预和监测研究，制定有效的对策和措施，促进健康素养水平的全面提高。

Objective To understand the residents health literacy and its 3 dimensions of literacy level distribution between the age of 15 and 69 years in Huaian city and explore its influential factors to provide evidence for health education strategies and measures through the investigation on health literacy in 2013, Methods Residents aged 15-69 years were surveyed in Qinghe, Qingpu, Huaian, Huaiyin counties by using a cross-sectional survey method and stratified multi-stage cluster random sampling from October to December, 2013. This research included demographic data, such as age, gender, occupation and 3 dimensions of health literacy namely （ basic knowledge and concepts, health lifestyle and behavior, and basic skills）. The influencing factors of health literacy level were analyzed with chi-square test and logistic regression. Results Of the 2 316 15 to 69 years old residents, 401 people had health literacy, their health literacy level was 17.3%. Basic knowledge and ideas, healthy lifestyle and behavior, basic skills literacy levels were 28.4%, 11.6% and 19.4%. The single factor analysis showed that the health literacy of residents in urban areas and the level of 3 dimensions of the degree of education increased with the degree of education And were higher in those with family per capita income （yuan）〉 10 000 than in those with less than or equal to 10 000, groups of different age, different occupational groups had significant difference （P〈 0.05）. Moreover, the level of basic skills of the male was higher than the female （P〈 0.05）. Multivariate logistic regression analysis showed that, effects of education on health literacy 0R（95% CI） value is 1.473 （1.337-1.623）, on the basic knowledge and literacy concept influence 0R（95% CI） value was 1.399 （1.289- 1.520）, to the effect of a healthy lifestyle and behavior literacy 0R（95% CI） values were 1.556 （1.386- 1.746）, on the basic skills of literacy effects 0R（95% CI） values are 1.400（1.275-1.538） .With respect to the farmers, the influence of enterprise workers, white-collar workers on health literacy OR （95% CI） values were 1.559 （1.095-2.219） and 2.333 （1.468-3.706）, on the basic knowledge and literacy concept influence OR （95% CI） values were 1.390 （1.063-1.819） and 1.778 （1.204-2.625）, on the basic skills of literacy effects OR （95% CI） values were 1.721（1.235-2.397） and 2.151（1.375-3.365）, with respect to the farmers, the mental workers on the impact of a healthy lifestyle and behavior literacy 0R（95% CI） value was 1.876 （1.093-3.220）. These are all positively correlated factors of health literacy. Conclusion The health literacy level of residents aged from 15 to 69 years in Huaian was 17.3%, and the level is low. The health literacy intervention and monitoring should be strengthened, effective policies and measures should be formulated to promote the health literacy level of counties.