江苏省淮安市常住居民健康素养影响因素分析

目的 了解江苏省淮安市常住居民健康素养水平分布状况,并探索其影响因素,为制定健康教育干预策略和措施提供依据.方法 采用分层多阶段整群随机抽样的方法,于2012年9至12月对淮安市15～ 69岁3 480名常住居民进行问卷调查,调查内容分为基本知识和理念、健康生活方式和行为、基本技能等三个维度;按健康问题分为科学健康观、传染病预防、慢性病预防、安全与急救、基本医疗和其他等6类.对健康素养水平影响因素进行x2检验和Logistic回归分析.结果 3 480名调查对象具备健康素养水平的人数为424名,健康素养水平为12.2％.单因素分析显示,城乡、性别、不同年龄组、不同文化程度、不同职业人群、家庭年收入高低,健康素养水平差异均有统计学意义（P＜0.05）.多因素Logistic回归分析显示,相对于农村,城市对健康素养影响的OR （95％ CI）值为1.558（1.234～ 1.966）;相对于不识字或识字很少,小学、初中、高中/职高/中专、大专/本科及以上对健康素养影响的OR（95％CI）值分别为4.651 （2.327～9.295）、9.833 （5.121～ 18.880）、15.451 （7.798～ 30.615）和22.937（10.766～ 48.870）;相对于公务员,医务人员对健康素养影响的OR（95％CI）值为3.789（1.292～11.114）;相对于家庭年收入＜30 000元,≥30 000元对健康素养影响的OR（95％CI）值为1.478（1.149～1.901）,是健康素养的促进（危险）因素.结论 淮安市15～ 69岁常住居民健康素养水平为12.2％,健康素养水平较低,应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.

Affacting factors of health literacy among Huaian residents

Objective To evaluate health literacy and its affacting factors in of Huaian residents so as to provide evidence for comprehensive health education. Methods A total of 3 480 subjects aged 15-69 years old were recruited from Huaian city in the second half of 2012 by using stratified multi-stage cluster random sampling. Three dimensions were covered in this investigation： basic knowledge and concept, healthy lifestyle and behavior, and basic skills. Six health problems were involved： scientific healthy concept, prevention of infectious disease, prevention of chronic disease, safety and first aid, basic medical and others. Chi-square test and logistic regression were used for data analysis. Results The health literacy ratio was 12.2% （424/3480）. In single factor analysis, urban and rural, gender, age, education, job, income were affecting factors of health literacy （P〈0.05）. Multiple regression analysis showed that the odds ratio （OR） （95% confidence interval （CI）） of urban vs rural areas was 1.558 （1.234-1.966）, OR （95%C/） of primary school vs illiteracy was 4.651 （2.327-9.295）, OR （95%C/） of junior high school vs illiteracy was 9.833 （5.121- 18.880）, OR （95%C/） of senior high school vs illiteracy was 15.451 （7.798-30.615）, and OR （95%C/） of undergraduate vs illiteracy was 22.937 （10.766-48.870）. In addition, OR （95%C/） was 3.789 （1.292-11.114） when medical personnel was compared with civil servants, and OR （95%C/） was 1.478 （1.149-1.901） when adults whose household income over ￥ 30 000 was compard with those below ￥ 30 000. Conclusion The rate of health literacy among Huaian residents was 12.2%. Health literacy intervention and monitoring should be strengthened and the preventive control measures should be established to improve residents＇ health literacy.