To explore the association between health literacy and medical out-of-pocket (MOOP) expenses among Chinese residents based on the 2020 China Health Literacy Survey. Non-institutionalized residents aged 15–69 years were extracted from 31 provinces in China. Health literacy was assessed using the Chinese Health Literacy Scale. A total of 49,967 respondents were included in this study. Compared to participants with adequate health literacy, participants with intermediate, basic, and below basic health literacy were likely to create more MOOP, the unadjusted coefficients being 224.294 (p < 0.05), 316.676 (p < 0.01), and 458.883 (p < 0.01) respectively. After adjusting for demographic characteristics and socio-economic elements, health literacy was significantly associated with MOOP (β = −4.970, SE = 2.470, p < 0.05). Of six dimensions of health literacy, five were associated with MOOP in unadjusted models (p < 0.001 or p < 0.01). However, in adjusted models, only infectious disease literacy (β = −52.347, SE = 17.853, p < 0.01) and medical care literacy (β = −29.603, SE = 10.620, p < 0.01) remained associated with MOOP. This study suggests that health literacy is significantly associated with medical expenditure. The adoption of disease prevention measures and the utilization of public health services are important elements. Improving health literacy should be give more importance in health promotion and public education for the general public.

BackgroundHigh-salt diet is an important risk factor for several non-communicable diseases. School-based health education has been found effective in reducing salt intake among children and their families in China. However, no such interventions have been scaled up in the real world. For this purpose, a study was launched to support the development and scale-up of an mHealth-based system (EduSaltS) that integrated routine health education and salt reduction and was delivered through primary schools. This study aims to elaborate the framework, development process, features, and preliminary scaling-up of the EduSaltS system.MethodsThe EduSaltS system evolved from previously successfully tested interventions to reduce family salt intake by empowering schoolchildren through school health education. EduSaltS was designed by following the WHO’s conceptual framework for developing a scaling-up strategy which accounted for the nature of the innovation, the capacity of the implementing organizations, the characteristics of the environment, the resources available, and type of scaling up. The system was then developed step by step from determination of online platform architecture, definition of component interventions and activities, development of specific educational materials and tools, to the development of the online/offline hybridized system. The system was tested and refined by a pilot in two schools and a preliminary scale-up in two cities in China.ResultsEduSaltS was developed as an innovative health education system, including an online WeChat-based education platform, a set of offline activities, and an actual administrative website showing the progress and setting the system. The WeChat platform could be installed on users’ smartphones to automatically deliver 20 sessions of five-minute well-structured cartoon video classes, followed by other online interactive activities. It also helps support project implementation and real-time performance evaluation. As a first-stage roll-out, a one-year course has been successfully implemented among 54,538 children and their families from 209 schools in two cities, and the average course completion rate was 89.1%.ConclusionAs an innovative mHealth-based health education system, EduSaltS was developed based on successfully tested interventions and an appropriate framework for scaling up. The early-stage roll-out has shown its preliminary scalability, and further evaluation is ongoing.

ObjectiveTo clarify the extent to which smokers in the general population experience tobacco withdrawal symptoms and whether such experience differs in those who continue to smoke and those who stopped smoking.MethodsWe included relevant questions in the nationally-representative China Health Literacy Survey (CHLS) conducted in 2018–2019. Among 87,028 participants, there were 22,115 ever-smokers aged 20–69 years who provided information on their smoking history and their experience of tobacco withdrawal symptoms. Multivariate logistic regressions were conducted to explore the association between withdrawal symptoms and other variables.ResultsAmong ever-smokers, there were 19,643 (88.8%) current smokers and 2,472 (11.2%) ex-smokers. Among current smokers, 61.3% reported having tried to quit smoking in the past. Overall, 61.1% of current smokers reported experiencing withdrawal symptoms: 69.9% of those who tried to quit smoking in the past and 47.5% of those who did not. A lower proportion of ex-smokers experienced withdrawal symptoms (46.3%) and the difference remained significant after controlling for demographic characteristics (OR = 1.76, 95% CI 1.62–1.93, P < 0.001). The most commonly reported withdrawal symptoms in both current smokers and ex-smokers were craving, restlessness and anxiety. In the multivariable-adjusted analyses, those who experienced withdrawal symptoms when they tried to quit smoking (OR: 2.05, 95% CI: 1.86–2.27) were less likely to successfully quit.ConclusionsThe clinical picture of the tobacco withdrawal syndrome is the same in current smokers and in ex-smokers, but ex-smokers are less likely to have experienced it. The experience of discomfort when unable to smoke is common and seems likely to be a major factor contributing to maintaining smoking behavior not just among individuals seeking help with quitting smoking, but among smokers generally.

Salt intake in China is very high, which increases the risk of hypertension and cardiovascular disease. This study aimed to assess the levels of salt-related knowledge, attitudes, and behaviors (KABs) and the factors that influence them and to explore the relationship between the scores of salt-related KAB and 24-h urinary sodium excretion. In 2018, we collected data from 5453 individuals aged 18–75 years from six provinces in China. A face-to-face survey was carried out, focusing on the KAB related to salt reduction. All participants were asked to collect one 24-h urine sample. Of the 5453 participants, 5352 completed urine collection. The mean score for overall KAB was 31.27 (SD = 9.18), which was composed of three elements: knowledge 4.80 (SD = 5.14), attitude 9.33 (SD = 3.93), and behavior 17.14 (SD = 4.43). The average 24-h urinary sodium excretion was 187.70 (SD = 77.48) mmol, which was equivalent to a urinary sodium excretion of 4.32 (SD = 1.78) g/d. We found that salt-related knowledge, attitude, behavior, and overall KAB scores were all inversely associated with 24-h urinary sodium excretion. For every one-point increase in the KAB score, the 24-h urinary sodium excretion decreased by 0.851 mmol (95% CI: −1.095, −0.602). We also found that location (rural/urban), sex, age, and education are associated with salt-related KAB scores. These results suggest that large-scale health education is needed to reduce salt intake in the Chinese population. In particular, efforts should be focused on reaching those who live in rural areas with low educational levels and older people.

Background: Alcohol dependence represents a chronic and relapsing disease. Little is known about its prevalence, risk factors, association with smoking and overall burden in China.Methods: The 2018 nationally representative China Health Literacy Survey (CHLS) included 87,028 participants aged 20-69 years, including 83,968 who provided information on smoking history and alcohol consumption, with the alcohol dependence assessed using CAGE test. Logistic regression was conducted to explore the association between alcohol dependence and other variables. We further estimated the total number of cases of alcohol dependence and co-use of smoking and drinking alcohol in China by applying present study findings to national population census data.Results: Overall, among current alcohol users, the prevalence of CAGE-questionnaire-defined alcohol dependence was 29.8%, significantly higher in men than in women (30.8% vs. 21.8%), translating into an overall prevalence of 7.3% (13.2% in men, 1.3% in women) in the general population. The prevalence of current alcohol and tobacco co-users was 14.1%, higher in men than women (27.3% vs. 0.6%) and highest in mild-aged (32%). Among man, the adjusted ORs (95% CI) for alcohol dependence were 1.54 (1.31, 1.08) for daily drinking alcohol, and 1.14 (1.08, 1.28) for current smoker. In addition, the risk of alcohol dependence was significantly associated with certain socioeconomic status (lower-income, rural residents) among males, but not among females. Furthermore, there was a dose-response association between smoking intensity and alcohol dependence among men, but not among women. In China, there were 72.6 million (95% CI: 65.1-80.9) alcohol dependent adults, and 139.9 million (95% CI: 128.3-152.3) co-users of alcohol and tobacco in 2018.Conclusion: In China, alcohol dependence is highly prevalent, approximately three out of ten alcohol being additive, which is strongly associated with tobacco dependence. Therefore, comprehensive tobacco control and smoking cessation strategy is advocated, especially in the middle-income and low-income areas in China.Funding Information: This study was supported by Chinese Academy of Medical Sciences (CAMS) Initiative for Innovative Medicine (CAMS 2021-I2M-1-010), Ministry of Finance of the People's Republic of China, and National Natural Science Foundation of China (grant no 81720108001).Declaration of Interests: The authors declared no conflicts of interest.Ethics Approval Statement: The study protocol was approved by the Ethics Review Committees of the China Health Education Center (Beijing, China). All participants provided signed informed consent.

ObjectiveTo explore the status and influencing factors of public health safety literacy (PHSL) among residents in four provinces of China for providing references to the development of appropriate intervention strategies. MethodsWe recruited 2 809 urban and rural residents aged 15 – 69 years in three provinces (Hubei, Guangdong and Sichuan) and Beijing municipality using stratified multistage cluster sampling and conducted an on-site self-administered electronic questionnaire survey among the residents during April – June, 2021. A scale with three domains (each with a maximum score of 40) was designed to assess the PHSL of the residents. T-test, one-way analysis of variance (ANOVA), and χ2 test were adopted in univariate analysis and logistic regression in multivariate analysis. Results For all the participants, the mean overall PHSL score was 81.61 ± 13.71 and the mean domain scores were 29.21 ± 5.89 for PHS perception, 25.10 ± 5.10 for PHS knowledge, and 27.30 ± 4.87 for PHS skills. There were 80.85% of the participants being assessed with basic PHSL (with the overall scale score of ≥ 72) and there were 86.69%, 61.05%, and 78.96% of the participants being assessed with basic PHS perception, knowledge, and skills (with the domain scores of ≥ 24); also based on the scale of overall score of ≥ 96 and domain scores of ≥ 32, the proportion of the participants with good PHSL was 15.70% and the proportions of participants with good PHS perception, knowledge and skills were 35.32%, 14.03% and 20.15%, respectively. Multivariate logistic regression analysis showed that PHSL was associated with residential region, sex, education and household income. The participants residing in Hubei, Sichuan, and Guangdong province were less likely to have basic/good PHSL, with the odds ratios (OR) of 0.485/0.422, 0.488/0.699, and 0.389/0.566 in contrast to those residing in Beijing municipality. The participants being female (versus male: OR = 1.336/1.283), with the education of higher than primary school education or below (junior high school: OR = 1.786/1.205; senior high or vocational or technical secondary school: OR = 2.204/2.013; college and above: OR = 2.932/3.710), with the annual household income of more than 30 000 RMB yuan (30 000 – 60 000: OR = 1.660/1.648; ≥ 120 000: OR = 1.865/2.145) were more likely to have basic/good PHSL. ConclusionFor 15 – 69 years old residents in four provincial administrative regions of China, the PHSL still needs to be improved and the residents′ PHSL is influenced mainly by gender, education, annual household income and residential region.

Background: In smokers seeking help with quitting, stopping smoking is typically accompanied by tobacco withdrawal symptoms such as craving and irritability. The prevalence and details of withdrawal symptoms in general population are less well mapped than in clinical samples. Here we report the patterns of tobacco withdrawal experience among a representative sample of smokers and ex-smokers in China.Methods: We used data from the nationally representative China Residents Health Literacy Survey (CRHLS) conducted in 2018-2019 . Among 87,028 participants, there were 22,115 ever-smokers (20,964 men and 1,151 women) aged 20~69 years who provided information on their smoking history and their experience of tobacco withdrawal symptoms. Multivariate logistic regressions were conducted to explore the association between withdrawal symptoms and smoking status and between withdrawal symptoms and participants’ characteristics.Findings: A total of 19,643 were current smokers and 2,472 were ex-smokers in this study. The mean age (SD) of current smokers was 49.7 (11.8) years, however, it was 53.6 (11.6) in ex-smokers (P<0.0001); 57.2% current smokers and 53.9% ex-smokers were resident in rural (P=0.0012); 61.3% current smokers have tried to quit smoking but failed. Among current smokers, 61.1% (11,993/19,643) have experienced at least one withdrawal symptom when unable to smoke, while among ex-smokers, the proportion was 46.3% (1,144/2472) (P<0.001). The most commonly reported withdrawal symptoms in both current smokers and ex-smokes, in the order of frequency, were craving, restlessness, anxiety, difficulty concentrating, and irritability. Among current smokers, presence of withdrawal symptoms was associated with higher nicotine dependence, heavier smoking (higher FTND, smoking pack-year, and smoking cigarettes per day), using manufactured cigarettes, starting smoking earlier, longer smoking duration, difficulty quitting, smoking a lot more than intended, being male, middle age and below, rural residents, lower income and poorer health, continued use of tobacco even following physical or mental health issues.Interpretation: Among general population in China, there are eight times as many smokers than ex-smokers. Among current smokers, two-third have tried to quit (or are motivated to quit) before. Less than half of ex-smokers have experienced tobacco withdrawal symptoms, while such experience is significantly more common among current smokers.Funding Information: National Key R&D Program of China (grant no 2017YFC1309400), Ministry of Finance of the People's Republic of China, and National Natural Science Foundation of China (grant no 81720108001). Declaration of Interests: The authors declared no conflicts of interest.Ethics Approval Statement: The study protocol was approved by the Ethics Review Committees of the China Health Education Center (Beijing, China). We informed each individual about the study's purpose and procedures, and all individuals signed informed consent before they were interviewed.

目的 分析"中国公众公共卫生安全素养自制量表"的项目功能差异(DIF),检验量表题项质量,为开发公共卫生安全素养(PHSL)调查工具提供依据.方法 通过经典测试理论和项目反应理论相结合的方法编制了单维的中国公众公共卫生安全素养量表.使用自制的初始量表(30个题项),于2021年4—6月随机抽取湖北、广东、北京和四川省的2809名常住居民进行调查.利用SPSS 23.0进行PHSL得分分析,两组间比较采用t检验,多组间比较采用单因素方差分析.利用R4.1.2软件mirt和scDIF test包对量表题项进行不同人口学特征的DIF检验.结果 调查对象PHSL的平均得分为(34.44±7.59)(满分44分).不同性别、年龄、文化程度、职业、地区、城乡、家庭年均总收入的公众PHSL得分差异均有统计学意义(P<0.001).其中,女性高于男性,文化程度较高人群高于较低人群,农民低于其他职业人群,湖北地区高于其他地区,城镇居民高于农村居民.所有题项均不存在性别、收入和城乡的DIF(P>0.05);8个题项存在年龄的DIF(P<0.05);8个题项存在文化程度的DIF(P<0.05);6个题项存在职业的DIF(P<0.05);4个题项存在地区的DIF(P<0.05).结论 中国公众公共卫生安全素养自制量表题项稳定性较好,适合推广使用.

Background Tobacco dependence is the key barrier to successful smoking cessation. However, little is known about its prevalence, sociodemographic characteristics and determinants. We aimed to estimate the prevalence, associated factors and burden of tobacco dependence in China. Methods During 2018-2019, the nationally representative 2018 China Health Literacy Survey (2018 CHLS) invited 87,708 participants to participate using a multistage stratified sampling method from 31 provinces (or equivalent) in mainland China, and 84,839 participants aged 20-69 with valid data were included in the analysis. We diagnosed tobacco dependence based on international criteria (ICD-10, DSM-4) and tailored to Chinese population according to China Clinical Guideline for Tobacco Cessation (2015 version). The prevalence of tobacco dependence was estimated overall and by sociodemographic factors. The Logistic regression was conducted to estimate odds ratios (OR) and 95% confidence intervals (CIs) for tobacco dependence and success of smoking cessation (being ex-smokers), with different levels of adjustment. These were used to estimate the total number of adults who were tobacco dependent in China. Findings In China, the estimated prevalence of current smoking was 25.1%, significantly higher in men than in women (47.6% vs 1.9%). The prevalence of current smoking varied approximately 3-fold (12.9% to 37.9%) across 31 provinces of China. Among general population aged 20-69 years, the prevalence of tobacco dependence was 13.1% (95% CI:12.2-14.1). Among current smokers, the prevalence of tobacco dependence was 49.7% (46.5-52.9%), with no difference between men and women (49.7% vs 50.8%). The prevalence of tobacco dependence was associated significantly with smoking intensity, defined by pack-years (1.62 [1.54-1.70] per 10 pack-years), cigarettes smoked per day (2.01 [1.78, 2.27] per 10 cigarettes), and smoking starting age (0.93 [0.90, 0.97] per 5 years). Given smoking intensity, the prevalence of tobacco dependence also varied by age, gender, certain socioeconomic status and regions. Compared with those without tobacco dependence, ever smokers with tobacco dependence were less likely to be ex-smokers (2.88, 2.59-3.21). In China, 183.5 (170.4-197.4) million adults (177.5 million were men) were tobacco dependent in 2018. Interpretation In China, tobacco dependence is highly prevalent, with approximately half of current smokers being addictive, highlighting the need for coordinated effort to improve awareness, diagnosis and treatment of tobacco dependence. Copyright (c) 2022 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Objective To understand salt-related knowledge, attitudes and behaviors（KABs） among residents in China. Methods A multi-stage random sampling method was used to recruit 5453 adults.After informed consent, the participants answered salt-related questionnaires.A series of chi-square tests were carried out to compare population groups across salt-related KABs. Results A total of 5408 valid questionnaires were collected, of which 2637（48.8%） were from males and 2771（51.2%） were from females.The awareness rates of maximum recommended salt intake for adults, the nutrition label of salt, and low sodium salt were 22.3%,43.1%,and 30.6%,respectively.Among the participants, 76.2% of them agreed that high salt intake would cause hypertension, 28.3% believed that low salt intake wouldn′t make people weakened, and 81.9% were willing to choose low salt diet.Among the participants, 10.4%,39.8%,8.2%,79.4%,and 17.2% reported using low-sodium salt at home, eating pickled foods more than once a week, eating salty snacks more than once a week, eating out or ordering delivery, and asking for less-salted meals when eating out.The differences in knowledge awareness and attitude agreement rates by age, education, and urban and rural areas were statistically significant（all P＜0.001）. Multivariate logistic regression analysis showed that the use of low-sodium salt of women were higher than men, with an OR value of 1.345（95%CI:1.115-1.623）. Compared with urban residents, rural residents had a lower use of low-sodium salt, with an OR of 0.651（95%CI:0.532-0.796）. Referring primary school or less educated group, the OR of junior school education was 4.332（95%CI:3.082-6.089） and 13.349（95%CI:9.505-18.747） in senior high school or above education. Conclusion We found that the awareness rate of knowledge and the holding rate of behavior were low, while the recognition rate of attitude was high in China.There is a long way to reduce salt intake in China.

目的 评价2019年河南省嵩县高血压患者自我管理的健康教育效果,为高血压患者有效管理提供参考.方法 从河南省洛阳市嵩县随机抽取干预村和对照村,每个村随机抽取16名高血压患者,根据排除标准确定对照组和干预组研究对象分别为90名和151名.干预村除开展常规健康教育外还实施为期3个月(2019年10—12月)的高血压患者自我管理教育干预.干预前后通过问卷调查对干预效果进行评估.结果 干预后,干预组和对照组的西药治疗率分别为98.7％和71.1％,控制饮食率分别为62.9％和26.7％,运动率分别为67.5％和20％,1周内测量血压的比例分别为70.2％和57.8％,均为干预组高于对照组,差异有统计学意义(P<0.05).吸烟和饮酒情况,干预后两组差异无统计学意义.干预后,干预组高血压健康知识得分为(12.2±1.9)分,高于对照组的(7.3±3.4)分(t=-14.439,P<0.001).结论 高血压自我管理教育能够有效提高患者高血压相关知识的掌握,推动患者采取更积极主动的措施和更有利于健康的生活方式进行高血压的治疗和管理.

推进医疗资源与养老服务融合,实现"健康老龄化",是我国积极应对人口老龄化的必然选择,是实现老有所养、老有所医的必要条件.目前,我国医养结合工作仍处于探索发展阶段,存在宏观政策缺乏落地细节、跨部门协调机制不健全、医疗服务仍偏重治疗与护理、医护和养护人员缺乏身份认同等问题.健康促进是一套涉及不同层面、内容丰富的理论体系,被认为是解决健康问题的综合策略,且具有普遍适用性的特点,广泛应用于疾病预防控制、突发公共卫生事件应对、妇幼保健等卫生健康领域.我国医养结合工作同样运用了健康促进理论与策略,采用"政府主导、多部门合作、全社会动员"的工作模式,以场所为基础开展相关工作,同时,强调健康教育的重要作用及老年人参与.

目的 比较高血压患者与一般人群健康素养水平的差异,探索健康素养对于高血压预防与控制的意义.方法 样本来源于2019年中国居民健康素养监测数据,将数据库中自报患有高血压者10605人和自报未患慢性病者56846人作为研究对象.采用中国健康教育中心编制的《中国居民健康素养量表》对调查对象健康素养进行测评,量表中包括6个高血压相关知识.结果 高血压患者具备健康素养的比例为10.01％(1062人),低于一般人群的16.13％(9168人),差异有统计学意义(P<0.05).高年龄组中,高血压患者的具备健康素养比例反而高于一般人群(P<0.05).高血压患者自测血压题目的正确率为50.34％,高于一般人群的48.54％(P<0.05).控制社会学特征和吸烟状况后,高血压患者与一般人群健康素养的差异无统计学意义,调整后OR值为1.074(95％CI:0.994～1.16).此外,健康素养与地区、年龄、文化程度、吸烟状况等因素有关.结论 高血压患者健康素养水平较低,应进一步加强其健康教育;同时要加强基础教育,并以中部和西部地区为重点区域.

采访嘉宾:中国健康教育中心党委书记、主任李长宁 问:作为国家级专业机构,中国健康教育中心在减盐方面开展了哪些工作? 答:中国健康教育中心是国家级健康教育专业机构,开发健康科普信息、开展健康科普活动是中心职责之一.近年来,中心在健康教育政策制定、健康城市建设、健康场所建设、城乡居民健康素养促进、健康知识传播普及等方面,开展了大量工作.其中,在营养宣传、减盐健康教育领域,中国健康教育中心主要开展了以下工作: 一是营养与健康一直是健康促进与教育工作的重要内容.

我国城市学龄儿童吃零食、喝饮料的现象比较普遍.2016年,一项在北京、上海、成都和宜昌开展的调查显示,儿童每周吃零食比例占94.6％.即使是在中西部贫困农村,学龄儿童吃零食的现象也很普遍.农村义务教育学生营养改善计划监测评估显示,2017年有18.8％的中小学生每日吃零食2次及以上,有39.2％的中小学生最常吃的零食是薯片等膨化食品.

目的 了解2012-2019年我国农村居民健康素养水平变化趋势,探讨农村居民健康素养的影响因素,为制定适合农村地区的健康促进政策提供依据.方法 对2012-2019年我国农村居民健康素养监测数据进行分析,对全国31个省(区、市)抽取的农村监测点的居民健康素养状况进行问卷调查.结果 2012年、2015年、2017年、2019年我国农村居民健康素养水平分别为7.13％、7.44％、10.64％和15.67％.对2019年监测数据进行多因素Logistic回归分析,结果表明2019年我国农村居民健康素养水平,东部地区(OR=1.586,95％CI:1.396～1.801)、中部地区(OR = 1.151,95％CI:1.001～1.324)高于西部地区.以15～24岁年龄段为参照,25～34岁(OR = 1.466,95％CI:1.231～1.745)、35～44岁(OR = 1.496,95％CI:1.262～1.773)、45～54岁(OR = 1.196,95％CI:1.008～1.419)年龄段健康素养水平较高.文化程度越高,健康素养水平越高,以不识字/少识字为参照,小学、初中、高中/职高/中专、大专/本科及以上文化程度健康素养水平OR值分别为2.963(95％CI:2.170～4.046)、6.979(95％CI:5.163～9.432)、16.182(95％CI:11.843～22.110)、31.731(95％CI:23.061～43.661).结论 我国农村居民健康素养水平处于较低水平,文化程度、地区、年龄是健康素养水平的主要影响因素.

目的 了解中国六地区家庭主厨和家庭成员减盐相关知识、态度和行为现状,为制定社区减盐干预策略和措施提供科学依据.方法 于2018年9-11月采用多阶段随机抽样方法抽取中国青海海南藏族自治州贵德县、河北邢台市任县、黑龙江鹤岗市萝北县、四川攀枝花市东区、江西上饶市横峰县和湖南常德市津市市六地区共1 576名家庭主厨及家庭成员进行减盐相关知识、态度、行为的问卷调查和血压测量.结果 中国六地区1 576名家庭主厨及家庭成员对成人每天食盐推荐量、低钠盐、食品标签含盐量指标、吃盐过多易得高血压和吃盐少不会没有力气等减盐相关知识的知晓率分别为16.24％、19.67％、31.41％、76.27％和20.11％,吃饭时持少盐态度的积极率为80.65％,食用低钠盐、不食用腌制食品、不食用含盐零食和在外就餐/点外卖时主动要求少放盐等行为的持有率分别为24.19％、53.87％、85.91％和14.91％;其中,家庭主厨对食品标签含盐量指标知识的知晓率(26.14％)低于家庭成员(36.68％),对吃盐过多易得高血压知识的知晓率(78.43％)高于家庭成员(74.11％),吃饭时愿意少盐态度的积极率(85.66％)高于家庭成员(75.63％),差异均有统计学意义(均P＜0.05).结论 中国六地区家庭主厨和家庭成员的减盐态度积极率较高,但总体减盐相关知识知晓率和减盐行为持有率相对较低.

目的 分析中国女性健康素养水平特点及变化趋势,为开展女性健康素养干预提供依据.方法 利用2012-2020年全国居民健康素养监测数据,选取有效样本中的女性人口进行分析.结果 2012-2020年,中国女性健康素养水平由9.09％提高到22.98％,其中城市地区、东部地区、45岁以下及初中以上文化程度女性提升幅度较大.各年份女性健康素养水平均与男性接近.对2020年数据进行单因素和多因素Logistic回归分析结果显示,中部地区(OR=0.705,95％CI:0.561～0.886)和西部地区(OR=0.589,95％CI:0.461～0.753)女性健康素养水平低于东部地区;25～34岁(OR= 1.338,95％CI:1.145～1.564)和35～44岁(OR = 1.558,95％CI:1.319～1.840)女性健康素养水平高于 15～24岁组,55～64岁组(OR =0.739,95％CI:0.607～0.900)低于 15～24岁组;文化程度为小学(OR=2.817,95％CI:2.038～3.894)、初中(OR=6.540,95％CI:4.592～9.316)、高中/职高/中专(OR = 12.911,95％CI:9.110～18.299)和大专/本科及以上(OR =31.089,95％CI:21.408～45.148)的女性健康素养水平高于不识字/少识字者.结论 2012-2020年,中国女性健康素养水平稳步提升,地区、年龄、文化程度是中国女性健康素养水平的影响因素.

问:什么是健康信息素养? 答:健康信息素养是指能够针对自身健康需求,有效获取、理解、甄别、评价、应用健康信息,从而做出正确决策的能力. 日常生活中,要有意识地关注健康信息.遇到健康问题时,能够积极主动地利用现有资源获取相关信息.对于各种途径传播的健康信息能够判断其科学性和权威性,不轻信、不盲从,优先选择政府、卫生健康行政部门、卫生健康专业机构、官方媒体等正规途径获取健康信息.对甄别后的信息能够正确理解,并自觉应用于日常生活,维护和促进自身及家人健康.

Introduction Health literacy is a critical determinant of health. However, the association between health literacy and outcomes among Chinese residents has not been studied using nationally representative data. This study examines the association between health literacy and self-rated health among Chinese residents based on the 2017 China Health Literacy Survey. Methods The 2017 China Health Literacy Survey was conducted among non-institutionalized residents aged 15–69 years from 31 provinces in China. Self-rated health was measured using a single question with a 1–5 scale. Health literacy was assessed using the Chinese Health Literacy Scale. Multilevel linear regression models examined the association between health literacy and self-rated health. Data were collected in 2017 and analyzed between 2018 and 2019. Results The final sample size was 85,384. The overall weighted mean of the self-rated health score was 4.02 (95% CI=4.00, 4.03). After adjusting for individual-, county-, and province-level covariates, Chinese residents with higher levels of health literacy were more likely to have better self-rated health (β=0.0007, SE=0.0002, p<0.001). Of 6 dimensions of health literacy, 4 (i.e., infectious diseases literacy, chronic diseases literacy, medical care literacy, and health information literacy) were associated with self-rated health. Additionally, self-rated health was associated with gender, age, education, occupation, annual household income, and chronic conditions. Conclusions Using nationally representative data collected in 2017, this study found that self-rated health is associated with health literacy among Chinese residents aged 15–69 years. The promotion of health literacy should be an important component of health education, patient management, and health promotion.