青岛市居民健康素养与健康状况的关系研究
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摘要
目的分析青岛市居民健康素养现状及其与慢性病患病、自评健康状况的关系,探讨健康素养对健康状况的影响,为健康教育干预措施和策略的制定提供依据。方法采用分层多阶段与人口规模成比例抽样(probability proportionate to size sampling,PPS)方法,2017年于青岛市抽取10个区(市) 16 700名15～69岁常住居民进行问卷调查。结果青岛市居民总体健康素养水平为15. 92%,慢性病患病率为19. 31%,自评健康状况好、一般和差的比例分别为81. 68%、12. 12%和1. 71%;有序Logistic分析显示,在调整城乡、性别、年龄、文化程度、收入、职业等因素后,健康素养是人群慢性病患病和自评健康的保护性因素(OR=1. 232,P=0. 003; OR=1. 159,P=0. 033),健康素养的三个方面均与人群慢性病患病和自评健康状况有关(均有P <0. 05)。结论健康素养与居民健康状况呈正相关关系,健康素养水平的提升是提高居民健康状况的重要途径。
Objective To analyze the status of health literacy and its relationship with chronic diseases and self-reported health among residents in Qingdao,discuss the influence of health literacy on health status and provide the scientific basis for the development of health education strategies and measures. Methods The stratified multistage and probability proportionate to population size sampling( PPS sampling) method was adopted in this investigation. In 2017,a questionnaire survey was conducted among 16 700 permanent residents aged 15-69 from 10 districts in Qingdao. Results The overall level of health literacy status was 15. 92%,the prevalence rate of chronic diseases was 19. 31%,the self-reported health proportion of good,fair and poor were 81. 68%,12. 12% and 1. 71% among residents in Qingdao. Logistic regression analysis showed that,after adjusting for urban and rural areas,gender,age,education,income and occupation,health literacy was a protective factor for people with chronic diseases and self-evaluated health( OR = 1. 232,P = 0. 003; OR = 1. 159,P = 0. 033). Three aspects of health literacy were correlated with chronic diseases and self-reported health among people( all P < 0. 05). Conclusions Health literacy is positively correlated with the health status of residents. The improvement of health literacy is an important way to enhance the health status of residents.
Objective To analyze the status of health literacy and its relationship with chronic diseases and self-reported health among residents in Qingdao,discuss the influence of health literacy on health status and provide the scientific basis for the development of health education strategies and measures. Methods The stratified multistage and probability proportionate to population size sampling( PPS sampling) method was adopted in this investigation. In 2017,a questionnaire survey was conducted among 16 700 permanent residents aged 15-69 from 10 districts in Qingdao. Results The overall level of health literacy status was 15. 92%,the prevalence rate of chronic diseases was 19. 31%,the self-reported health proportion of good,fair and poor were 81. 68%,12. 12% and 1. 71% among residents in Qingdao. Logistic regression analysis showed that,after adjusting for urban and rural areas,gender,age,education,income and occupation,health literacy was a protective factor for people with chronic diseases and self-evaluated health( OR = 1. 232,P = 0. 003; OR = 1. 159,P = 0. 033). Three aspects of health literacy were correlated with chronic diseases and self-reported health among people( all P < 0. 05). Conclusions Health literacy is positively correlated with the health status of residents. The improvement of health literacy is an important way to enhance the health status of residents.
引文
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[15]刘祥,扶雪莲,刘本燕,等.多水平视角下探讨老年人自评健康的影响因素[J].中华疾病控制杂志,2018,22(2):173-177.DOI:10.16462/j.cnki.zhjbkz.2018.02.017.Liu X,Fu XL,Liu BY,et al.Analysis on the influencing factors of self-rated health among the elderly by using multilevel model[J].Chin J Dis Control Prev,2018,22(2):173-177.DOI:10.16462/j.cnki.zhjbkz.2018.02.017.
[16]Berkman ND,Stacey LS,Katrina ED,et al.Low health literacy and health outcomes:an updated systematic review[J].Ann Intern Med,2011,155(2):97-107.DOI:10.7326/0003-4819-155-2-201107190-00005.
[17]詹思延.流行病学[M].北京:人民卫生出版社,2012:176.Zhan SY.Epidemiology[M].Beijing:People’s Medical Publishing House,2012:176.
[2]曾庆奇,常春.健康素养影响健康状况的研究进展[J].中国健康教育,2013,29(1):57-60.DOI:10.16168/j.cnki.issn.1002-9982.2013.01.004.Zeng QQ,Chang C.Effect research of health literacy on health outcome[J].Chin J Health Ed,2013,29(1):57-60.DOI:10.16168/j.cnki.issn.1002-9982.2013.01.004.
[3]孟琴琴,张拓红.健康自评指标研究进展[J].中国预防医学杂志,2010,11(7):750-752.DOI:10.16506/j.1009-6639.2010.07.002.Meng QQ,Zhang TH.Research progress on self-rated health indicators[J].Chin Prev Med,2010,11(7):750-752.DOI:10.16506/j.1009-6639.2010.07.002.
[4]Machacova K,Lysack C,Neufeld S.Self-rated health among persons with spinal cord injury:what is the role of physical ability[J].J Spinal Cord Med,2011,34(3):265-272.DOI:10.1179/107902610X12883422813660.
[5]李英华.2012年中国居民健康素养监测方案简介[J].中国健康教育,2014,30(6):563-565.DOI:10.16168/j.cnki.issn.1002-9982.2014.06.003.Li YH.Introduction of 2012 Chinese residents health literacy monitoring program[J].Chin J Health Ed,2014,30(6):563-565.DOI:10.16168/j.cnki.issn.1002-9982.2014.06.003.
[6]帅伟,张晓琦.山东省卫计委通报我省居民健康素养水平基本情况[EB/OL].(2015-02-11)[2018-05-03].http://health.dzwww.com/jkxw/shgz/201502/t20150211_11890970.htm.Shuai W,Zhang XQ.Commission of health and family planning reported the basic health literacy level of residents in Shangdong Province[EB/OL].(2015-02-11)[2018-05-03].http://health.dzwww.com/jkxw/shg2/201502/t20150211-11890970.htm.
[7]聂雪琼,李英华,李莉.2012年中国居民健康素养监测数据统计分析方法[J].中国健康教育,2014,30(2):178-181.DOI:10.16168/j.cnki.issn.1002-9982.2014.02.021.Nie XQ,Li YH,Li L.Statistic analysis of 2012 Chinese residents health literacy monitoring[J].Chin J Health Ed,2014,30(2):178-181.DOI:10.16168/j.cnki.issn.1002-9982.2014.02.021.
[8]World Health Organization Regional Office for Europe[R].Health Literacy:The Solid Facts,2013.
[9]李善鹏,綦斐,刘辉,等.青岛市居民健康素养状况调查[J].中国公共卫生管理,2014,30(5):647-649.DOI:10.19568/j.cnki.23-1318.2014.05.014.Li SP,Qi F,Liu H,et al.Status of resident health literacy in Qingdao[J].Chin.J of PHM,2014,30(5):647-649.DOI:10.19568/j.cnki.23-1318.2014.05.014.
[10]Berkman N,Sheridan S,Donahue K,et al.Low health literacy and health outcomes:an updated systematic review[J].Ann Intern Med,2011,155(2):97.DOI:10.7326/0003-4819-155-2-201107190-00005.
[11]Sentell T,Zhang W,James D,et al.The influence of community and individual health literacy on self-reported health status[J].JGen Intern Med,2014,29(2):298-304.DOI:10.1007/s11606-013-2638-3.
[12]Young IC,Shoou-Yih DL,Ahsan MA,et al.Effects of health literacy on health status and health service utilization amongst the elderly[J].Soc Sci Med,2008,66(8):1809-1816.DOI:10.1016/j.socscimed.2008.01.003.
[13]James E Rohrer,Ahmed Arif,Anne Denison,et al.Overall selfrated health as an outcome indicator in primary care[J].J Eval Clin Pract,2007,13(6):882-888.DOI:10.1111/j.1365-2753.2006.00766.x.
[14]温秀芹,赵洁,曾庆奇,等.提高老年人群健康素养对其基本公共卫生服务利用的影响研究[J].中华疾病控制杂志,2016,20(2):204-206.DOI:10.16462/j.cnki.zhjbkz.2016.02.025.Wen XQ,Zhao J,Zeng QQ,et al.Influence of increasing health literacy on utilization of essential public health services among elderly population[J].Chin J Dis Control Prev,2016,20(2):204-206.DOI:10.16462/j.cnki.zhjbkz.2016.02.025.
[15]刘祥,扶雪莲,刘本燕,等.多水平视角下探讨老年人自评健康的影响因素[J].中华疾病控制杂志,2018,22(2):173-177.DOI:10.16462/j.cnki.zhjbkz.2018.02.017.Liu X,Fu XL,Liu BY,et al.Analysis on the influencing factors of self-rated health among the elderly by using multilevel model[J].Chin J Dis Control Prev,2018,22(2):173-177.DOI:10.16462/j.cnki.zhjbkz.2018.02.017.
[16]Berkman ND,Stacey LS,Katrina ED,et al.Low health literacy and health outcomes:an updated systematic review[J].Ann Intern Med,2011,155(2):97-107.DOI:10.7326/0003-4819-155-2-201107190-00005.
[17]詹思延.流行病学[M].北京:人民卫生出版社,2012:176.Zhan SY.Epidemiology[M].Beijing:People’s Medical Publishing House,2012:176.