| BackgroundHealth literacy is a personal comprehensive ability of accessing, understanding and processing basic health information and services, and making appropriate health care decisions based on these information and services to maintain and promote own health. It has been proven by a number of studies that it is independent factor of affecting public health outcomes and medical costs. WHO pointed out that the health literacy of residents in developed and developing countries is limited.As a major public health problem, Health literacy is highly valued by governments and researchers of every country. WHO regards health literacy as one of the most promising new ideas and new strategies of health education and health promotion in new century. In 2005, at the Sixth World Health Promotion Conference in Bangkok, "Bangkok Charter for Global Health" is adopted, and the key action and target of health promotion is to improve people's health literacy. The U.S. government regards increasing public health literacy as one of the goals of "Health People 2010" and one of the 20 priority areas of health care reform in USA.In 2007, Chinese Government has emphasized that enhancement the people's health literacy is one of the three basic elements of improving the population quality in the" Research Report of National Population Development Strategy". In January 2008, the Ministry of Health issued "Chinese citizen health literacy-basic knowledge and skills (for trial implementation)", which is the first government documents in the world to make a comprehensive definition for the content of basic health literacy. Based on it, the Ministry of Health organized experts to compile a "Healthy 66-Chinese citizen health literacy Reading", and the 66 main elements of this reading are explained. In May of the same year, a start Ceremony of Chinese citizen health literacy promotion action cum "the Reading" premiere was held in Beijing. In 2008, organized by the Ministry of Health, Supported by China Health Education Center, the first Chinese residents nationwide health literacy survey is launched, this study is one part of it and focus on Hunan province.ObjectiveThe purpose of this study is to find out the overall level and the various dimensions of sub-level of health literacy of residents in Hunan Province at the present, analysis the main factors, find the weaknesses. At the same time, some interventions will be made to improve residents' ability of health management and promote their health status.MethodologyIn this study, a multi-stage stratified random sampling method is selected, and six survey points are chosen. Three city points located at Changsha, Shaoyang, Hengyang and three rural points located at Shaodong, Hengyang and Taoyuan.500 samples from 15 to 69-year-old at each point are selected and the total sample number is 3000. The questionnaire is developed by Chinese Health Education Center based on Delphi method, and investigators are trained. The survey is made by face to face and the response rate is 100%. According to health-related behavior change theory and the major health problems in Hunan Province, the health literacy levels of residents are analyzed respectively from attitude, knowledge, behavior, skills, basic healthcare, disease prevention and control, safety and first aid aspects. Ordinal logistic regressions are used to determine the major factors of health literacy. Based on education statistical grouping method, the critical value of health literacy scores are made from low to high, they are,0%to 26%,27%to 73%,74%to 100%, and health literacy is divided into poor, middle and good according to the critical value of demarcation point. Then, the overall level of population health literacy can be figured out based on the population percentage in each group.ResultFrom the attitudes, knowledge, behavior, skills perspective, the skill literacy is the lowest and the average score is only 10.09, followed by health action literacy which average score is 16.01. The average score of attitude literacy is 32.28 and health knowledge literacy is 57.37. From the basic health care, disease prevention and control, safety and first aid point of view, the safety and emergency literacy got the lowest score and it is 25.62, followed by the basic health literacy with an average score of 39.78. Disease prevention and control got 50.25. The overall average score of health literacy is 115.05 in Hunan Province.In this survey, most of Hunan residents got the middle-scale grade, next is lowest, and the least is the highest grade. In attitude literacy dimension,45%of residents got middle grade,29.13%of them got low grade and 25.87%of them got high grade. In knowledge literacy dimension,46.10%of residents got middle grade,28.43%of them got low grade and 25.47%of them got high grade. In behavior literacy dimension,47.10%of residents got middle grade,38.00%of them got low grade and 14.90%of them got high grade. In skill literacy dimension, 49.17%of residents got middle grade,33.03%of them got low grade and 17.80%of them got high grade. In basic healthcare literacy dimension, 45.07%of residents got middle grade,28.47%of them got low grade and 26.47%of them got high grade. In disease prevention and control literacy dimension,47.60%of residents got middle grade,28.03%of them got low grade and 24.37%of them got high grade. In safety and first aid literacy dimension,40.63%of residents got middle grade,34.77%of them got low grade and 24.60%of them got high grade. As a whole, 45.80%of residents got middle grade,28.03%of them got low grade and 26.17%of them got high grade.The following aspects got higher rate of positive answers, these are, regular health check-up (95.17%), consumption of iodized salt (94.53%), immunization (92.67%), sedative analgesic use (92.47%), traffic safety (90.20%), knowledge of drug abuse (87.33%), the Occupational Safety (84.60%), blood donation (82.77%), health food is no substitute for drugs (82.73%), relationship between health and environment (78.40%), the rational use of antibiotics (76.67%), health implications (75.53%), AIDS (74.80%), TB transmission (72.07%). The others got lower positive answer, such as, obese (39.53%), first aid and haemostatic methods (33.47%), adult daily intake of milk (29.63%), water contamination may cause diseases (26.00%), respiratory cardiac arrest (24.33%), fracture of the wounded disposal (22.97%), tuberculosis treatment (18.53%), adult day alcohol consumption (18.13%), drug manual understanding (16.97%), flies, mosquitoes, rats, cockroaches four common bio-borne diseases (7.00%), diseases caused by passive smoking (6.13%), flammable, explosive high-pressure, poisonous and other dangerous symbol recognizing (0.68%).The various dimensions of urban residents and the total health literacy scores were higher than rural residents in Hunan, and the difference was statistically significant (P＜0.001). the scores on behavior of female residents is higher than male, but their scores on knowledge, disease prevention and control, safety and first aid, and total score are lower than male's, and the difference was statistically significant (P <0.05). The differences of Han and minority residents in health literacy every dimension and total scores are not statistically significant. The health literacy of 35-age group are higher than other groups, but the health literacy of 65 to 69-year-old residents were lower than other groups, the difference statistically significant (P＜0.001). With the increase of ages, the scores of residents on every dimension and total scores showed a downward trend. These residents with under primary school degree got the lowest scores on each dimension and total scores. The group of collage got the highest scores on each dimension and total, and the scores increase with the level of education increase, and the difference between the groups was statistically significant (P＜0.001). Unmarried group, divorce group got the highest scores on each dimension and total, but widowed group got the lowest scores, and the difference between the two groups was statistically significant (P＜0.001). Family group with 1 to 3 persons got the highest scores, and family group with more than eight persons got the lowest score, and the difference between the two group is statistically significant (P<0.001). The group with average monthly income less than 500 RMB got the lowest score on each dimension and total evaluation. The group with average monthly income more than 2000 RMB got a higher score than other groups on attitude dimension. With the increase of average monthly income, the resident's health literacy is on the rise. The difference of migrant workers and production personnel on each dimension are no differences (P>0.05), and scores lower than other occupational groups (P<0.001). Technical personnel got high scores on each dimension and total evaluation. Ordinal logistic regression analysis showed that degree of education, income,occupation, age and family size are the major factors of health literacy level of residents in Hunan Province.Conclusion(1) The health literacy of the resident in Hunan Province is medium. It is coincident with the economic, cultural and health development situation in Hunan province.(2) Ordinal logistic regression analysis shows that degree of education, income, occupation, age and family size are the independent factors of resident health literacy level in Hunan.(3) With the actual situation in Hunan Province, at this stage we could choose elderly population having more diseases, migrant workers living in the worst conditions, female who acted as a key role in family healthcare and management as intervention object, cooperate with communities, enterprises and media, utilize the advantages of interpersonal communication and mass communication, carry out various, flexible, content-rich and acceptable health promotion activities to absorb people engage in and promote their health literacy level.(4) The key interventions of health literacy are to change the life style with occurrence of chronic diseases and to strengthen health skills training of first-aid skills.
|
PDF Full Text Request