新冠肺炎疫情前后某市居民健康素养水平变化分析

目的 比较新冠疫情前后苏北某市城市居民健康素养水平变化情况，为制定科学合理的干预措施提供建议。方法 采用分层多阶段与人口规模成比例抽样（PPS 抽样）方法，2018年、2020年分别抽取苏北某市804名和829名15~69岁主城区常住人口作为研究对象，使用《全国居民健康素养监测调查问卷》对居民健康素养水平进行测评。结果 2018年和2020年居民总体健康素养水平分别为20.27%（95%CI:17.49%~23.06%）和26.30%（95%CI:23.29%~29.30%），差异有统计学意义（〖XC小五号.EPS;P〗=8.278，P=0.004）。2020年城市居民基本知识和理念、健康生活方式与行为、基本技能3个方面的素养分别为35.22%、29.43%、26.78%，比2018年增加了2.38%（〖XC小五号.EPS;P〗=1.036，P=0.309）、3.68%（〖XC小五号.EPS;P〗=2.775，P=0.096）、4.52%（〖XC小五号.EPS;P〗=4.492，P=0.034）。2020年城市居民科学健康观、传染病防治、慢性病防治、安全与急救、基本医疗、健康信息6类健康问题素养分别为52.59%、34.14%、24.00%、62.24%、29.07%、56.82%，比2018年增加了1.35%（〖XC小五号.EPS;P〗=0.298，P=0.585）、7.03%（〖XC小五号.EPS;P〗=9.466，P=0.002）、2.61%（〖XC小五号.EPS;P〗=1.586，P=0.208）、1.54%（〖XC小五号.EPS;P〗=0.413，P=0.521）、2.20%（〖XC小五号.EPS;P〗=0.985，P=0.321）、7.07%（〖XC小五号.EPS;P〗=8.184，P=0.004）。2020年15~59岁组人群部分健康素养水平高于2018年（P<0.05），老年人均无统计学意义（P>0.05）。对应图显示，2020年15~44岁人群与“科学健康观”、 “健康信息” 和“传染病防治”这3类问题的距离减小；45~59岁人群与 “基本医疗”的距离减小；而60~69岁人群与全部6类问题的距离增大。提示老年人对疫情防控措施反应不灵敏，是健康素养水平提高的薄弱环节。结论 新冠疫情防控措施实施前后15~59岁人群健康素养水平有明显提高，但对老年人提高不大，应开展形式更多、内容更广的健康教育和健康促进活动提高老年人健康素养水平。

Changes of health literacy among residents in a city before and after COVID-19 epidemic

To compare the changes of urban residents’ health literacy in a city in Northern Jiangsu Province under the COVID-19 pandemic, so as to provide suggestions for formulating scientific and rational intervention measures. Methods Using the stratified multi-stage proportional sampling(PPS sampling) method, 804 and 829 main urban area permanent residents aged 15-69 in a city of Northern Jiangsu Province in 2018 and 2020 respectively were selected as the research objects, and the survey was conducted using the uniformly prepared "National Resident Health Literacy Monitoring Questionnaire". Results The overall health literacy levels of residents in 2018 and 2020 were 20.27%(95%CI: 17.49%-23.06%) and 26.30%(95%CI: 23.29%-29.30%) respectively, with significant difference(X²=8.278, P=0.004). In 2020, the literacy levels of basic knowledge and concept, healthy lifestyle and behavior, and basic skills of urban residents were 35.22%, 29.43%, and 26.78%, respectively, which increased by 2.38%(X²=1.036, P=0.309), 3.68%(X²=2.775, P=0.096), and 4.52%(X²=4.492, P=0.034) compared with 2018. In 2020, the literacy levels of scientific health concept, prevention and control of infectious diseases, prevention and control of chronic diseases, safety and first aid, basic medical treatment and health information of urban residents were 52.59%, 34.14%, 24.00%, 62.24%, 29.07% and 56.82% respectively, which increased by 1.35%(X²=0.298, P=0.585), 7.03%(X²=9.466, P=0.002), 2.61%(X²=1.586, P=0.208), 1.54%(X²=0.413, P=0.521), 2.20%(X²=0.985, P=0.321) and 7.07%(X²=8.184, P=0.004) compared with 2018. In 2020, partial health literacy level of the people aged 15-59 was higher than that in 2018(P<0.05), but not in the elderly(P>0.05). The corresponding figure showed that the distance between people aged 15-44 and the three types of problems, namely "scientific health concept", "health information" and "infectious disease prevention and control", decreased in 2020. The distance between people aged 45-59 and "basic medical care" was decreased. However, the distance between people aged 60-69 and all six kinds of problems increased. It was suggested that the elderly, who were insensitive to epidemic prevention and control measures, were the weak link to improve the level of health literacy. Conclusion Before and after the implementation of the epidemic prevention and control measures in COVID-19, the health literacy level of people aged 15-59 has obviously improved, but not much for the elderly. More forms of more extensive health education and promotion activities should be carried out.