陈婉莉, 张成钢, 王现, 崔子禕, 王继伟, 余金明. 上海市徐汇区居民健康素养水平及社会资本对其的影响[J]. 环境与职业医学, 2019, 36(5): 479-483, 489. DOI: 10.13213/j.cnki.jeom.2019.18689
引用本文: 陈婉莉, 张成钢, 王现, 崔子禕, 王继伟, 余金明. 上海市徐汇区居民健康素养水平及社会资本对其的影响[J]. 环境与职业医学, 2019, 36(5): 479-483, 489. DOI: 10.13213/j.cnki.jeom.2019.18689
CHEN Wan-li, ZHANG Cheng-gang, WANG Xian, CUI Zi-yi, WANG Ji-wei, YU Jin-ming. Health literacy of residents and impact of social capital in Xuhui District, Shanghai[J]. Journal of Environmental and Occupational Medicine, 2019, 36(5): 479-483, 489. DOI: 10.13213/j.cnki.jeom.2019.18689
Citation: CHEN Wan-li, ZHANG Cheng-gang, WANG Xian, CUI Zi-yi, WANG Ji-wei, YU Jin-ming. Health literacy of residents and impact of social capital in Xuhui District, Shanghai[J]. Journal of Environmental and Occupational Medicine, 2019, 36(5): 479-483, 489. DOI: 10.13213/j.cnki.jeom.2019.18689

上海市徐汇区居民健康素养水平及社会资本对其的影响

Health literacy of residents and impact of social capital in Xuhui District, Shanghai

  • 摘要: 背景 健康素养是居民健康的重要决定因素,同时也是评价健康教育与健康促进工作的关键指标。探索健康素养的影响因素,对于提高健康素养水平尤为重要。社会资本可以促进健康知识的传播,从而对健康素养产生影响。

    目的 了解上海市徐汇区居民的健康素养现状,探索社会资本对健康素养的影响,为健康素养的干预提供有效靶点。

    方法 采用2017年全国居民健康素养监测调查问卷和社会资本量表对上海市该区居民进行问卷调查,共发放问卷640份,回收600份,回收率93.75%,问卷有效率100%。全国居民健康素养监测调查问卷包括三个方面,分别为基本知识和理念、健康生活方式与行为、基本技能;社会资本量表包括五个方面,分别为社会支持、社会参与、社交网络、对生活的掌控和对社区的感受。对人口学特征进行描述性分析,并使用卡方检验比较健康素养在不同人口学特征方面的差异。将是否具备健康素养作为应变量,人口学特征和社会资本作为自变量进行logistic回归分析。

    结果 被调查者600人,其中男性275人,占45.8%,女性325人,占54.2%。年龄以60~74岁组为主,占41.8%。具备基本健康素养的人数为213人,具备率为35.5%;基本知识和理念、健康生活方式与行为、基本技能的具备率分别为34.2%、31.7%和49.0%。健康素养以及健康素养的两个维度(健康生活方式与行为、基本技能)具备率在受教育程度上的差异有统计学意义(均P < 0.05);初中及以下、高中与大专及以上三组的健康素养具备率分别为26.7%、32.1%和45.0%,呈现受教育程度越高,具备健康素养的比例越高的趋势。人口学特征、社会资本各维度与健康素养的logistic回归分析结果表明:社交网络(OR=1.081,95% CI为1.019~1.147)和社会支持(OR=1.084,95% CI为1.023~1.149)水平是影响健康素养的主要社会资本因素;此外,社会支持水平是基本知识和理念(OR=1.115,95% CI为1.066~1.167)及健康生活方式与行为(OR=1.141,95% CI为1.088~1.196)的影响因素,社交网络(OR=1.095,95% CI为1.036~1.157)和社会支持(OR=1.072,95% CI为1.018~1.130)水平是基本技能的影响因素。

    结论 受教育程度是健康素养水平的影响因素,提升健康素养应重点关注受教育程度较低的群体。整体社会资本和社会资本维度中的社交网络和社会支持可能与健康素养水平具有一定的相关性,可考虑通过改善社会资本来提高居民的健康素养水平,从而改善居民健康状况。

     

    Abstract: Background Health literacy is an important determinant of residents' health, and also a key indicator for evaluating health education and health promotion. Exploring the factors that influence health literacy is especially important for improving health literacy levels. Social capital can promote the spread of health knowledge and thus affect health literacy.

    Objective The purpose of this study is to investigate the health literacy status of community residents in Xuhui District of Shanghai, explore the impact of social capital on health literacy, and provide an effective target for health literacy intervention.

    Methods A cross-sectional survey of residents from the district of Shanghai was conducted using the 2017 National Health Literacy Monitoring Questionnaire and the Social Capital Scale. A total of 640 questionnaires were distributed, and 600 were recovered. The recovery rate was 93.75% and the percentage of recovered questionnaires valid for analysis was 100%. The National Health Literacy Monitoring Questionnaire consisted of three aspects:health knowledge and concept, healthy lifestyle and behaviors, and basic skills. The Social Capital Scale included five aspects:social support, social participation, social network, control of life, and feelings for the community. Descriptive analysis of demographic characteristics was carried out, and chi-square tests was used to compare health literacy scores across selected demographic characteristics. Logistic regression analysis was conducted with health literacy scores as a dependent variable and selected demographic characteristics & social capital as independent variables.

    Results There were 600 respondents, including 275 males (45.8%) and 325 females (54.2%). The largest age group was 60-74 years old, accounting for 41.8%. The number of people with basic qualified health literacy was 213, accounting for 35.5%. The proportions of people with qualified health knowledge and concept, healthy lifestyle and behaviors, and basic skills were 34.2%, 31.7% and 49.0%, respectively. The two dimensional (healthy lifestyles and behaviors, health skills) and total scores of health literacy had statistically significant differences across educational attainment categories (Ps < 0.05). The proportions of residents with qualified health literacy in middle school and below, high school, and college and above group were 26.7%, 32.1%, and 45.0%, respectively. The higher education level was attained, the higher proportion of residents with qualified health literacy were. The logistic regression analysis results showed that social network (OR=1.081, 95%CI:1.019-1.147) and social support (OR=1.084, 95%CI:1.023-1.149) were the main social capital related factors affecting health literacy level. In addition, social support was the influencing factor of health knowledge and concept (OR=1.115, 95%CI:1.066-1.167) and healthy lifestyle and behavior (OR=1.141, 95%CI:1.088-1.196), while social network (OR=1.095, 95%CI:1.036-1.157) and social support (OR=1.072, 95%CI:1.018-1.130) were the influencing factors of basic skills.

    Conclusion Education level is an impact factor of health literacy level, and the promotion of health literacy should focus on groups with lower education levels. Social support and social network in social capital are associated with health literacy level. The health literacy level of residents may be ameliorated by improving social capital, so as to improve the health status of residents.

     

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