杭州市居民健康城市建设参与度研究

Participation in Healthy City Construction Programs among urban and rural residents of Hangzhou municipality

目的了解当前杭州市居民健康城市建设活动参与情况,为今后杭州市健康城市建设相关政策的制定提供科学依据。方法采用多阶段随机抽样方法,在2017年1月抽取杭州市下城区、余杭区和桐庐县共3个区(县),对社区中年龄15~75岁的居民进行杭州市健康城市建设参与问卷调查,共收回4200份问卷,其中有效问卷3913份,有效率为93.2%。结果杭州市居民的健康城市建设活动的总参与率为65.82%。健康文化,健康人群、健康环境三类活动参与率分别为69.01%、66.59%和66.30%,占据前三。不同性别、地区、年龄、婚姻状况、职业、文化程度、收入情况的居民主动参与度比较差异均有统计学意义(P<0.001)。不同特征人群活动参与条目数和参与率如下:男性16273(66.54%),女性14631(65.04%);城市居民12649(67.44%),城镇居民9319(62.23%),农村居民8939(67.60%);15~17岁1751(49.97%);18~44岁14962(66.42%),45~59岁8853(68.67%),60~75岁5995(66.65%);未婚6428(58.80%),已婚23221(68.09%),离婚775(70.97%),丧偶人群483(58.33%);机关人群3503(76.42%),企业工人8084(63.23%),个体户2578(66.72%),商业服务2272(63.32%),农民3679(65.65%),学生3375(52.28%),离退休5324(69.87%);不识字人群460(59.51%),小学2568(62.21%),初中6980(65.36%),高中9066(63.22%),大专/本科11279(69.06%),硕士及以上546(75.83%);收入<2000元3453(57.66%),2001~5000元17826(66.73%),5001~8000元6332(67.56%),8001~11000元1908(63.10%),>11000元1385(66.71%)。多因素分析结果显示,居民对健康城市建设活动总体参与情况的影响因素为婚姻状况、文化程度、职业、地区分布,家庭人均月收入;另外,有10项健康城市建设活动的居民参与对总体活动参与有影响,其中五水共治,家庭庭院改造活动,慢病干预的参与对总体活动参与的影响占前三位。结论杭州市居民健康城市建设活动参与水平有所提升,但主动参与度仍需提高。居民对建设活动的参与度程度不同,应分层次开展健康城市建设宣传工作。

Objective To examine the status quo of participation in Healthy City Construction Programs(HCCPs)among residents in Hangzhou city and to provide evidences for developing strategies for Healthy City construction.Methods We selected 4200 residents aged 15 to 75 years in 28 urban communities or rural villages in 2 districts and one county of Hangzhou municipality with stratified multistage random sampling and carried out a household questionnaire survey among the residents in January,2017.Results Of the 3913 residents with valid information,65.82%reported the participation in HCCPs;the top three program contents with higher reported participation rate were healthy culture(69.01%),healthy population(66.59%),and healthy environment(66.30%),respectively.The reported rate for active participation in HCCPs differed significantly by sex,living region,age,marital status,occupation,education,and income(P<0.001 for all)among the residents and the total number of person-times(rate)of participation in various HCCPs among different groups of the residents were as following:16273(66.54%)and 14631(65.04%)for the male and female residents;12649(67.44%),9319(62.23%),and 8939(67.60%)for the urban,township residents,and rural residents;1751(49.97%),14962(66.42%),8853(68.67%),and 5995(66.65%)for the residents aged 15–17,18–44,45–59,and 60–75 years;6428(58.80%),23221(68.09%),775(70.97%),and 483(58.33%)for the unmarried,married,divorced,and widowed residents;3503(76.42%),8084(63.23%),2578(66.72%),2272(63.32%),3679(65.65%),3375(52.28%),and 5324(69.87%)for the residents being public institution staff,enterprise worker,self-employed entrepreneur,commercial service person,peasant,student,and retiree;460(59.51%)for the illiterate;2568(62.21%),6980(65.36%),9066(63.22%),546(75.83%),and 11279(69.06%)for the residents with the education of primary school,junior high school,senior high school,junior college or undergraduate,and graduate education;3453(57.66%),17826(66.73%),6332(67.56%),1908(63.10%),and 1385(66.71%)for the residents with family monthly income per capita of<2000,2001–5000,5001–8000,8001–11000,and>11000 RMB yuan.The results of multivariate analyses indicated that marital status,educational background,occupation,living region,family monthly income per capita were significant factors influencing the residents′participation in HCCPs.There were 10 items of HCCPs contributing significant impacts on the overall rate of participation in HCCPs among the residents and comprehensive management on natural/drinking/waste water,family garden renovation,and intervention on chronic disease prevalence were the top three with most strong impact.Conclusion The participation in Healthy City Construction Programs has been improved among the residents in Hangzhou city but active participation of the residents needs to be promoted and targeted disseminations of the programs should be carried in various groups of the residents.