社区公共健康教育对中国流动人口健康的影响——机制与检验

Study on the Infuence of Community Public Health Education on the Health of Migrants in China from Theoretical Mechanism and Empirical Test.

目的:探究社区公共健康教育对流动人口健康的影响及其作用机制。方法:基于2017年全国流动人口动态监测调查数据169910份样本,使用Logistic和Probit模型分析对流动人口职业病防治、性病/艾滋病防治、生殖健康与避孕、结核病防治、控制吸烟、心理健康、慢性病防治、妇幼保健/优生优育等九方面进行健康教育及健康知识普及后对其自身身体健康状况的影响。结果:对流动人口进行社区公共健康教育可以显著改善流动人口的健康水平(β=0.051,P<0.001),社区公共健康教育可以显著改善年龄超过60岁老人(β=0.069,P<0.001)、女性(β=0.061,P<0.001)、高中以下学历(β=0.057,P<0.001)、流动到省外(β=0.051,P<0.001)、地处东部地区(β=0.053,P<0.001)的流动人口健康水平。此外,社区公共健康教育通过政府公共卫生服务配置作用于流动人口的健康行为,采用互联网数字平台教育(β=0.063,P<0.001)和面对面的教育方式(β=0.057,P<0.001)的健康教育对流动人口健康影响效果突出。结论:社区公共健康教育对流动人口健康水平有显著的正影响,且对流动人口不同细分人群的影响存在异质性。政府公共服务配置在社区健康教育与流动人口健康水平之间存在中介作用,互联网数字平台教育和面对面教育提升流动人口的健康素养和健康水平有积极作用,应该充分重视社区公共卫生健康教育,积极引导重点人群充分利用社区公共健康教育服务平台和资源,加快推动公共健康教育知识的推广普及,着力为新发展阶段努力践行“健康中国”战略擘画新蓝图。

Objective To explore the effects and mechanism of community public health education on the health of migrants in China.Methods 169,910 samples from the China Migrants Dynamic Survey(CMDS)in 2017 were selected to analyze by using Lo-gistic and Probit models.Results Community public health education could significantly improve the health level of the migrants(β=0.051,P<0.001),which had a greater impact on the health of elders over 60 years old(β=0.069,P<0.001),fermales(β=0.061,P<0.001),having education background below high school(β=0.057,P<0.001),outside the province(β=0.051,P<0.001)and located in the eastern region(β=0.053,P<0.001).In addition,the efect on the migrants through the public health education of Internet digital platform education(β=0.063,P<0.001)and face-to-face education(β=0.057,P<0.001)was prominent.Conclusion Community public health education had significantly positive influence on the health of mi-grants,which had heterogeneity in different populations.The governmental public services allocation had intermediate effect be-tween community public health education and the health of migrants.And Internet digital platform education and face-to-face education played a positive role in improving the health literacy and health level of floating population.It is suggested to pay full at-tention to community public health education,actively guide key groups to make full use of community public health education service platforms and resources,and accelerate the popularization of public health education knowledge,and draw up a new blue-print for the implementation of the"Healthy China"strategy in the new development stage.