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Article(id=1241759333579554853, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241759317016252418, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202401484, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1706544000000, receivedDateStr=2024-01-30, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773988095897, onlineDateStr=2026-03-20, pubDate=1727193600000, pubDateStr=2024-09-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773988095897, onlineIssueDateStr=2026-03-20, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773988095897, creator=13701087609, updateTime=1773988095897, updator=13701087609, issue=Issue{id=1241759317016252418, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='18', pageStart='3265', pageEnd='3456', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773988091898, creator=13701087609, updateTime=1773991617194, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241774103024174010, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241759317016252418, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241774103024174011, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241759317016252418, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=3351, endPage=3357, ext={EN=ArticleExt(id=1241759334443581487, articleId=1241759333579554853, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Analysis of the changes and influencing factors of women’s health literacy, Nanchang, 2018-2023, columnId=null, journalTitle=Modern Preventive Medicine, columnName=null, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the changes and influencing factors of female health literacy level in Nanchang, and to provide reference for intervention in female health literacy.

Methods

Based on the health literacy monitoring of residents in Nanchang from 2018 to 2023, analyze the data of 10 034 women in the effective sample. Conduct inter-group difference comparisons and influencing factor analyses on the health literacy levels of women with different characteristics by using the χ2 test and Logistic regression model. And analyze the changes in the health literacy of women in Nanchang City using the χ2 trend test.

Results

From 2018 to 2023, the level of female health literacy in Nanchang showed rising year by year, increased from 17.87% to 30.80%. Health knowledge and concept as well as safety and first aid ranked first in three aspects and six dimensions of health literacy. The factors affecting female health literacy in Nanchang included regions, age, education, occupation and marriage. The health literacy level of urban women was 1.249 times higher than that of rural women (OR=1.249, 95%CI: 0.934-1.669; The health literacy level of women aged 35-44 was 93.5% higher than that of women aged 15-24; The health literacy level of women with junior college and above (OR=15.851, 95% CI: 12.525-20.060) was 15.851 times higher than that of women with primary school and below; The health literacy level of female civil servants/teachers and other employees of public institutions (OR=0.373, 95%CI: 0.252-0.553) and female farmers (OR=0.368, 95%CI: 0.231-0.585) were significantly lower than female medical staff; Unmarried women had a higher level of health literacy than married women by 45.5% (OR=0.545, 95%CI: 0.332-0.896).

Conclusion

The level of female health literacy in Nanchang has been improved. In the future, infectious and chronic disease prevention and basic medical literacy should be the key content. Focusing on key population such as women of farmers, the elderly, lower education level and low-income, targeted health education and promotion activities will be innovatively carried out to popularize healthy lifestyles and skills.

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目的

分析2018—2023年南昌市女性健康素养变化情况和影响因素，为干预女性健康素养提供依据。

方法

在2018—2023年南昌市居民健康素养监测的基础上，对有效样本中10 034名女性数据进行分析。通过χ2检验和logistic回归模型对不同特征女性健康素养水平进行组间差异比较及影响因素分析，并利用χ2趋势检验分析南昌市女性健康素养的变化情况。

结果

2018—2023年，南昌市女性健康素养水平逐年上升，从17.87%提升到30.80%。其中，健康知识和理念及安全与急救分别在健康素养三方面和六维度中居首位。影响南昌市女性健康素养的因素有城乡、年龄、文化程度、职业和婚姻状况。城市女性健康素养水平是农村女性的1.249倍（OR=1.249，CI:0.934～1.669）；35～44岁组女性健康素养水平比15～24岁组高93.5%（OR=1.935,95%CI:1.375～2.724）；大专及以上（OR=15.851，95% CI: 12.525~20.060）女性健康素养水平是小学及以下女性的15.851倍；职业为公务员/教师及其他事业单位（OR=0.373,95% CI:0.252～0.553）和农民（OR=0.368,95% CI:0.231～0.585）的女性健康素养水平明显低于女性医务人员；未婚女性健康素养水平高于在婚女性45.5%（OR=0.545，95% CI: 0.332~0.896）。

结论

南昌市女性健康素养水平有所提升，今后要以基本医疗、传染病和慢性病防治素养为重点内容，以农民、老年、低文化程度和低收入女性为重点人群，创新开展有针对性的健康教育和促进活动，普及健康生活方式与技能。

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谢晓艳，E-mail：
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张淑云（1979—），女，硕士，副主任中医师，研究方向：健康促进

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* A：健康素养总体水平；B：健康素养三个方面；C：健康素养六个维度；D：城乡；E：年龄；F：文化程度；G：职业；H：婚姻状况；I：个人年收入。

, figureFileSmall=4Eo8gOYwWyT0kaHO59qYwg==, figureFileBig=//rD59ylc63gV41BJWMBDg==, tableContent=null), ArticleFig(id=1241759352420369154, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759333579554853, language=EN, label=Table 1, caption=

Health literacy levels and changes of women with different characteristics in Nanchang City from 2018 to 2023[n(%)]

, figureFileSmall=null, figureFileBig=null, tableContent=
人口学特片2018年2019年2020年2021年
城乡
城市1 561(24.70)507(28.80 )631(35.39)889(38.71)
农村1 170(9.64)562(10.18)742(17.22)639(15.46)
年龄组（岁）
15～24149(18.06)54(18.32)114(28.25)65(37.94)
25～343 246(27.00)149(38.05)173(37.03）212(40.95)
35～44476(21.66)176(28.20)211(31.73)314(39.00)
45～54667(12.42)273(12.75)346(19.00)361(16.96)
55～691 093(6.67)417(8.11)529(10.84)576(10.19)
文化程度
小学及以下1 036(2.75)440(0.48)502(8.58)460(4.36)
初中744(7.05)267(8.53)363(11.42)351(9.34)
高中/职高/中专508(18.63)178(21.76)223(31.85)279(23.02)
大专及以上443(38.32)184(48.71)285(44.69)438(60.35)
职业
医务人员56(48.78)27(52.19)29(70.80)44(61.33)
公务员、教师及其他事业单位人员193(38.16)98(35.44)182(36.55)227(43.34)
学生58(18.24)27(20.86)74(30.52)23(49.92)
农民1 002(3.25)491(0.80)606(10.50)508(7.86)
工人348(8.89)142(21.60)155(15.07)191(12.01)
其他企业人员200(31.69)141(35.33)184(34.36)282(38.04)
其他874(17.23)143(19.46)143(20.61)253(23.25)
婚姻状况
未婚139(18.76)59(20.41)129(31.92)113(46.15)
在婚2 389(17.44)915(22.41)1 155(24.49)1 290(22.94)
分居/离异/丧偶203(22.64)95(15.84)89(25.54)125(13.93)
个人年收入（元）
<10 000990(9.14)422(6.88)496(15.35)392(16.26)
10 000～30 0001 238(17.04)437(23.99)535(25.05)511(25.09)
>30 000503(37.97)205(37.53)266(42.78)441(43.98)
合计2 731(17.87)1 069(21.71)1 373(26.50)1 528(28.32)
人口学特征2022年2023年合计χ2值P值
城乡19.5480.002
城市1 049(35.24)928(34.35)5 565(33.09)
农村603(22.92)753(27.28)4 469(17.84)
年龄组（岁）34.441<0.001
15～2485(30.07)84(38.05)551(28.58)
25～34270(45.04)251(41.53)1 401(37.87)
35～44309(38.89)295(37.02)1 781(32.62)
45～54391(23.29)435(23.54)2 473(18.60)
55～69597(14.14)616(12.32)3 828(10.77)
文化程度65.729<0.001
小学及以下424(11.61)445(10.08)3 307(6.23)
初中407(14.19)417(18.21)2 549(11.58)
高中/职高/中专312(24.89)316(26.56)1 816(24.34)
大专及以上509(53.35)503(51.91)2 362(51.30)
职业29.664<0.001
医务人员49(72.10)44(71.47)249(62.06)
公务员、教师及其他事业单位人员322(38.65)266(30.89)1 288(36.71)
学生33(31.89)27(32.51)242(32.05)
农民454(11.85)490(16.33)3 551(9.12)
工人227(19.36)177(19.10)1 240(15.23)
其他企业人员374(38.93)405(40.25)1 586(37.28)
其他193(30.67)272(30.23)1 878(22.90)
婚姻状况7.5660.023
未婚160(34.33)148(41.31)748(33.55)
在婚1 328(28.53)1 386(27.51)8 463(23.98)
分居/离异/丧偶164(30.94)147(16.60)823(21.60)
个人年收入（元）7.9070.019
<10 000439(14.99)383(23.72)3 122(14.13)
10 000～30 000610(30.83)622(26.45)3 953(24.69)
>30 000484(43.77)445(44.82)2 344(42.24)
合计1 652(30.20)1 681(30.80)10 034(26.26)51.501<0.001
), ArticleFig(id=1241759352571364105, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759333579554853, language=CN, label=表1, caption=

南昌市2018—2023年不同特征女性健康素养水平及变化情况[n（%）]

, figureFileSmall=null, figureFileBig=null, tableContent=
人口学特片2018年2019年2020年2021年
城乡
城市1 561(24.70)507(28.80 )631(35.39)889(38.71)
农村1 170(9.64)562(10.18)742(17.22)639(15.46)
年龄组（岁）
15～24149(18.06)54(18.32)114(28.25)65(37.94)
25～343 246(27.00)149(38.05)173(37.03）212(40.95)
35～44476(21.66)176(28.20)211(31.73)314(39.00)
45～54667(12.42)273(12.75)346(19.00)361(16.96)
55～691 093(6.67)417(8.11)529(10.84)576(10.19)
文化程度
小学及以下1 036(2.75)440(0.48)502(8.58)460(4.36)
初中744(7.05)267(8.53)363(11.42)351(9.34)
高中/职高/中专508(18.63)178(21.76)223(31.85)279(23.02)
大专及以上443(38.32)184(48.71)285(44.69)438(60.35)
职业
医务人员56(48.78)27(52.19)29(70.80)44(61.33)
公务员、教师及其他事业单位人员193(38.16)98(35.44)182(36.55)227(43.34)
学生58(18.24)27(20.86)74(30.52)23(49.92)
农民1 002(3.25)491(0.80)606(10.50)508(7.86)
工人348(8.89)142(21.60)155(15.07)191(12.01)
其他企业人员200(31.69)141(35.33)184(34.36)282(38.04)
其他874(17.23)143(19.46)143(20.61)253(23.25)
婚姻状况
未婚139(18.76)59(20.41)129(31.92)113(46.15)
在婚2 389(17.44)915(22.41)1 155(24.49)1 290(22.94)
分居/离异/丧偶203(22.64)95(15.84)89(25.54)125(13.93)
个人年收入（元）
<10 000990(9.14)422(6.88)496(15.35)392(16.26)
10 000～30 0001 238(17.04)437(23.99)535(25.05)511(25.09)
>30 000503(37.97)205(37.53)266(42.78)441(43.98)
合计2 731(17.87)1 069(21.71)1 373(26.50)1 528(28.32)
人口学特征2022年2023年合计χ2值P值
城乡19.5480.002
城市1 049(35.24)928(34.35)5 565(33.09)
农村603(22.92)753(27.28)4 469(17.84)
年龄组（岁）34.441<0.001
15～2485(30.07)84(38.05)551(28.58)
25～34270(45.04)251(41.53)1 401(37.87)
35～44309(38.89)295(37.02)1 781(32.62)
45～54391(23.29)435(23.54)2 473(18.60)
55～69597(14.14)616(12.32)3 828(10.77)
文化程度65.729<0.001
小学及以下424(11.61)445(10.08)3 307(6.23)
初中407(14.19)417(18.21)2 549(11.58)
高中/职高/中专312(24.89)316(26.56)1 816(24.34)
大专及以上509(53.35)503(51.91)2 362(51.30)
职业29.664<0.001
医务人员49(72.10)44(71.47)249(62.06)
公务员、教师及其他事业单位人员322(38.65)266(30.89)1 288(36.71)
学生33(31.89)27(32.51)242(32.05)
农民454(11.85)490(16.33)3 551(9.12)
工人227(19.36)177(19.10)1 240(15.23)
其他企业人员374(38.93)405(40.25)1 586(37.28)
其他193(30.67)272(30.23)1 878(22.90)
婚姻状况7.5660.023
未婚160(34.33)148(41.31)748(33.55)
在婚1 328(28.53)1 386(27.51)8 463(23.98)
分居/离异/丧偶164(30.94)147(16.60)823(21.60)
个人年收入（元）7.9070.019
<10 000439(14.99)383(23.72)3 122(14.13)
10 000～30 000610(30.83)622(26.45)3 953(24.69)
>30 000484(43.77)445(44.82)2 344(42.24)
合计1 652(30.20)1 681(30.80)10 034(26.26)51.501<0.001
), ArticleFig(id=1241759352705581843, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759333579554853, language=EN, label=Table 2, caption=

Logistic Regression Variable Assignments

, figureFileSmall=null, figureFileBig=null, tableContent=
编码变量名赋值
Y健康素养得分<53分判定其不具备健康素养=0；得分≥53分判定其具备健康素养=1；
X1城乡城区=0；农村=1
X2年龄15～24 =1；25～34 =2；35～44 =3；45～54 =4；55～69=5
X3文化程度小学及以下=1；初中=2；高中/职高/中专=3；大专及以上=4
X4职业医务人员=1；公务员/教师/其他事业单位人员=2；学生=3；农民=4；工人=5；其他企业人员=6；其他=7
X5婚姻状况未婚=1；在婚=2；分居/离异/丧偶=3
X6个人年收入（元）<10 000=1；10 000～30 000=2；>30 000=3
), ArticleFig(id=1241759352894325535, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759333579554853, language=CN, label=表2, caption=

Logistic回归变量赋值

, figureFileSmall=null, figureFileBig=null, tableContent=
编码变量名赋值
Y健康素养得分<53分判定其不具备健康素养=0；得分≥53分判定其具备健康素养=1；
X1城乡城区=0；农村=1
X2年龄15～24 =1；25～34 =2；35～44 =3；45～54 =4；55～69=5
X3文化程度小学及以下=1；初中=2；高中/职高/中专=3；大专及以上=4
X4职业医务人员=1；公务员/教师/其他事业单位人员=2；学生=3；农民=4；工人=5；其他企业人员=6；其他=7
X5婚姻状况未婚=1；在婚=2；分居/离异/丧偶=3
X6个人年收入（元）<10 000=1；10 000～30 000=2；>30 000=3
), ArticleFig(id=1241759353003377452, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759333579554853, language=EN, label=Table 3, caption=

Logistic analysis of women’s health literacy in Nanchang City in 2023

, figureFileSmall=null, figureFileBig=null, tableContent=
自变量（参照组）βWald χ2OR95%CIP值
上限下限
城乡（农村）
城市0.9197.1781.2490.9341.669<0.001
年龄组（岁）（15～24）
25～34-0.1610.8561.8821.3262.6710.392
35～440.4723.4241.9351.3752.7240.001
45～540.5003.8231.8571.3192.615<0.001
55～690.4593.8871.1740.8121.697<0.001
文化程度（小学及以下）
初中-3.1649.2421.8721.4522.413<0.001
高中/职高/中专-2.5377.7594.4553.2746.062<0.001
大专及以上-2.76323.04515.85112.52520.060<0.001
职业（医务人员）
公务员、教师及其他事业单位人员0.9304.1550.3730.2520.553<0.001
学生-0.0560.3910.6420.3741.1020.696
农民0.4872.0890.3680.2310.5850.037
工人-0.0710.4850.3460.2210.5420.628
其他企业人员-0.1330.8480.4180.2840.6150.397
其他0.0570.4430.3950.2540.6120.658
婚姻状况（未婚）
在婚0.7992.2240.5450.3320.8960.019
分居/离异/丧偶0.1931.2130.4500.2350.8610.435
人均年收入（元）（<10 000）
10 000～30 000-0.5020.6051.0030.6481.5520.099
>30 000-0.4990.6071.6530.9003.0340.069
), ArticleFig(id=1241759353225675583, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241759333579554853, language=CN, label=表3, caption=

2023年南昌市女性健康素养logistic分析

, figureFileSmall=null, figureFileBig=null, tableContent=
自变量（参照组）βWald χ2OR95%CIP值
上限下限
城乡（农村）
城市0.9197.1781.2490.9341.669<0.001
年龄组（岁）（15～24）
25～34-0.1610.8561.8821.3262.6710.392
35～440.4723.4241.9351.3752.7240.001
45～540.5003.8231.8571.3192.615<0.001
55～690.4593.8871.1740.8121.697<0.001
文化程度（小学及以下）
初中-3.1649.2421.8721.4522.413<0.001
高中/职高/中专-2.5377.7594.4553.2746.062<0.001
大专及以上-2.76323.04515.85112.52520.060<0.001
职业（医务人员）
公务员、教师及其他事业单位人员0.9304.1550.3730.2520.553<0.001
学生-0.0560.3910.6420.3741.1020.696
农民0.4872.0890.3680.2310.5850.037
工人-0.0710.4850.3460.2210.5420.628
其他企业人员-0.1330.8480.4180.2840.6150.397
其他0.0570.4430.3950.2540.6120.658
婚姻状况（未婚）
在婚0.7992.2240.5450.3320.8960.019
分居/离异/丧偶0.1931.2130.4500.2350.8610.435
人均年收入（元）（<10 000）
10 000～30 000-0.5020.6051.0030.6481.5520.099
>30 000-0.4990.6071.6530.9003.0340.069
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2018—2023年南昌市女性健康素养变化及影响因素研究
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张淑云 1 , 刘影 2 , 刘伟 1 , 谢晓艳 1
现代预防医学 | 基层卫生服务 2024,51(18): 3351-3357
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现代预防医学 | 基层卫生服务 2024, 51(18): 3351-3357
2018—2023年南昌市女性健康素养变化及影响因素研究
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张淑云1, 刘影2, 刘伟1, 谢晓艳1
作者信息
  • 1.南昌市卫生健康促进中心 江西 南昌 330008
  • 2.中国疾病预防控制中心控烟办

    • 张淑云（1979—），女，硕士，副主任中医师，研究方向：健康促进

通讯作者:

谢晓艳，E-mail：
Analysis of the changes and influencing factors of women’s health literacy, Nanchang, 2018-2023
Shu-yun ZHANG1, Ying LIU2, Wei LIU1, Xiao-yan XIE1
Affiliations
  • Nanchang Health Promotion Center, Nanchang, Jiangxi 330008, China
出版时间: 2024-09-25 doi: 10.20043/j.cnki.MPM.202401484
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摘要
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目的

分析2018—2023年南昌市女性健康素养变化情况和影响因素，为干预女性健康素养提供依据。

方法

在2018—2023年南昌市居民健康素养监测的基础上，对有效样本中10 034名女性数据进行分析。通过χ2检验和logistic回归模型对不同特征女性健康素养水平进行组间差异比较及影响因素分析，并利用χ2趋势检验分析南昌市女性健康素养的变化情况。

结果

2018—2023年，南昌市女性健康素养水平逐年上升，从17.87%提升到30.80%。其中，健康知识和理念及安全与急救分别在健康素养三方面和六维度中居首位。影响南昌市女性健康素养的因素有城乡、年龄、文化程度、职业和婚姻状况。城市女性健康素养水平是农村女性的1.249倍（OR=1.249，CI:0.934～1.669）；35～44岁组女性健康素养水平比15～24岁组高93.5%（OR=1.935,95%CI:1.375～2.724）；大专及以上（OR=15.851，95% CI: 12.525~20.060）女性健康素养水平是小学及以下女性的15.851倍；职业为公务员/教师及其他事业单位（OR=0.373,95% CI:0.252～0.553）和农民（OR=0.368,95% CI:0.231～0.585）的女性健康素养水平明显低于女性医务人员；未婚女性健康素养水平高于在婚女性45.5%（OR=0.545，95% CI: 0.332~0.896）。

结论

南昌市女性健康素养水平有所提升，今后要以基本医疗、传染病和慢性病防治素养为重点内容，以农民、老年、低文化程度和低收入女性为重点人群，创新开展有针对性的健康教育和促进活动，普及健康生活方式与技能。

南昌市  /  女性  /  健康素养  /  变化  /  影响因素
Objective

To analyze the changes and influencing factors of female health literacy level in Nanchang, and to provide reference for intervention in female health literacy.

Methods

Based on the health literacy monitoring of residents in Nanchang from 2018 to 2023, analyze the data of 10 034 women in the effective sample. Conduct inter-group difference comparisons and influencing factor analyses on the health literacy levels of women with different characteristics by using the χ2 test and Logistic regression model. And analyze the changes in the health literacy of women in Nanchang City using the χ2 trend test.

Results

From 2018 to 2023, the level of female health literacy in Nanchang showed rising year by year, increased from 17.87% to 30.80%. Health knowledge and concept as well as safety and first aid ranked first in three aspects and six dimensions of health literacy. The factors affecting female health literacy in Nanchang included regions, age, education, occupation and marriage. The health literacy level of urban women was 1.249 times higher than that of rural women (OR=1.249, 95%CI: 0.934-1.669; The health literacy level of women aged 35-44 was 93.5% higher than that of women aged 15-24; The health literacy level of women with junior college and above (OR=15.851, 95% CI: 12.525-20.060) was 15.851 times higher than that of women with primary school and below; The health literacy level of female civil servants/teachers and other employees of public institutions (OR=0.373, 95%CI: 0.252-0.553) and female farmers (OR=0.368, 95%CI: 0.231-0.585) were significantly lower than female medical staff; Unmarried women had a higher level of health literacy than married women by 45.5% (OR=0.545, 95%CI: 0.332-0.896).

Conclusion

The level of female health literacy in Nanchang has been improved. In the future, infectious and chronic disease prevention and basic medical literacy should be the key content. Focusing on key population such as women of farmers, the elderly, lower education level and low-income, targeted health education and promotion activities will be innovatively carried out to popularize healthy lifestyles and skills.

Nanchang  /  Women  /  Health literacy  /  Changing  /  Influence factor
张淑云, 刘影, 刘伟, 谢晓艳. 2018—2023年南昌市女性健康素养变化及影响因素研究. 现代预防医学, 2024 , 51 (18) : 3351 -3357 . DOI: 10.20043/j.cnki.MPM.202401484
Shu-yun ZHANG, Ying LIU, Wei LIU, Xiao-yan XIE. Analysis of the changes and influencing factors of women’s health literacy, Nanchang, 2018-2023[J]. Modern Preventive Medicine, 2024 , 51 (18) : 3351 -3357 . DOI: 10.20043/j.cnki.MPM.202401484
正文
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提升人民健康素养是提高全民健康水平最根本、最经济、最有效的措施之一，近年来，我国积极开展健康促进行动，持续提升居民健康素养水平以推动全民健康。女性作为人类文明的奠基者、社会进步的推动者，其健康状况不仅与个人福祉息息相关，还对新生儿素质、家庭幸福以及社会发展产生深远影响。本研究基于2018—2023年南昌市居民健康素养监测数据，研究女性健康素养水平的变化情况和影响因素，为提升女性健康素养水平提供科学依据。
1　对象与方法
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1.1　对象
2018—2023年南昌市居民健康素养监测点中15～69岁女性常住人口，最终纳入有效样本10 034人。
1.2　方法
1.2.1　抽样方法
根据中国居民健康素养监测方案要求[1]，在城乡分层后，采用基于人口比例的整群抽样方法（PPS）在南昌市12个县（区）抽取28～61个街道（乡镇），随后在抽中的街道（乡镇）抽取2个社区（村），使用简单随机法在确定的社区（村）选择60个住户，再依据KISH抽样技术从各个住户中选取一位年龄介于15～69岁的常住居民作为调查对象。
1.2.2　调查方法和内容
将《全国居民健康素养监测调查问卷》导入专业系统，调查员应用调查软件进行入户调查。问卷主要收集调查对象社会人口学数据以及健康素养三个方面（基本知识和理念、健康生活方式与行为、健康技能）和六个维度（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）的测评项目。健康素养水平的计算原则为全国居民健康素养监测统一评价标准[2]，判断题、单选题回答正确计1分，多选题回答选项与正确答案完全一致计2分，错选、漏选计0分，情景题判分标准与单选题、多选题一致，实际得分占应得总分的80％及以上视为具备健康素养水平。
1.2.3　质量控制
调查员培训合格后再入户调查；质控员采用现场指导和查听后台数据的方式进行质量控制；督导员通过现场或电话复核的方式进行督导，合格问卷的比例低于80%则判定该监测社区（村）现场调查工作不达标，该监测社区（村）需重新调查。
1.2.4　统计分析
应用SPSS 25.0软件进行统计分析。文中健康素养水平均为加权调整后的结果。采用描述性统计方法分析不同特征女性健康素养水平状况，不同特征亚组间比较采用χ2检验，并通过χ2趋势检验分析南昌市女性健康素养水平随时间的变化趋势。利用logistic回归模型探索南昌市女性健康素养水平的影响因素。
2　结果
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2.1　基本情况
数据显示，2018—2023年南昌市健康素养监测中女性有效样本分别为2 731、1 069、1 373、1 528、1 652、1 681人，南昌市女性健康素养水平从2018年的17.87%提升到2023年的30.80%，差异具有统计学意义（χ2=51.501，P<0.001），在城乡（χ2=19.548，P=0.002）、年龄（χ2=34.441，P<0.001）、文化程度（χ2=65.729，P<0.001）、职业（χ2=29.664，P<0.001）、婚姻状况（χ2=7.566，P=0.023）、个人年收入（χ2=7.907，P=0.019）方面均呈现统计学差异。详见表1。
2.2　南昌市女性健康素养变化趋势
χ2趋势检验表明，2018—2023年南昌市女性健康素养水平及其三个方面、六个维度均呈上升趋势（r>0，P<0.001）。健康素养的三个方面中，健康生活方式与行为提升最为明显，健康技能最低，两者均低于基本知识和理念素养。在六个维度中，传染病防治、慢性病防治和基本医疗素养提升最为明显，但仍低于其他维度水平。在城乡方面，城市和农村女性健康素养水平均有明显提高，在不同年份均表现为城市地区女性健康素养水平高于农村，但城乡之间的差距逐步缩小；在年龄方面，25～34岁组最高，35~69岁女性健康素养水平随着年龄的增大而逐渐降低，15～24岁组提升幅度最为明显；女性健康素养水平随着文化程度的提升而上升，大专及以上文化程度提升幅度最大；职业类别中，从事医务工作的女性健康素养水平居首位，而农民居末位，两者提升幅度较其他职业人群更大；婚姻状况方面，未婚女性健康素养水平高于其他婚姻状况的女性且增速最快；在经济收入方面，女性健康素养水平随着经济收入的提升而上升，但个人年收入低于10 000元的提升幅度最大。详见图1。
2.3　2023年南昌市女性健康素养多因素logistic回归分析
将城乡、年龄、文化程度、职业、婚姻状况和个人年收入作为自变量，以是否具备健康素养作为因变量（变量赋值见表2），进行多因素logistic回归分析。结果显示，南昌市女性健康素养受城乡、年龄、文化程度、职业及婚姻状况的影响；城市女性健康素养水平是农村女性的1.249倍（OR=1.249，P<0.001）；以15~24岁组女性为对照，35~44岁、45~54岁和55~69岁组女性的健康素养水平分别比对照组高93.5%（OR=1.935，95% CI: 1.375~2.724）、85.7%（OR=1.857，95% CI: 1.319~2.615）和17.4%（OR=1.174，95% CI: 0.812~1.697）；大专及以上、高中/职高/中专和初中文化程度的女性健康素养水平分别是小学及以下组的15.851倍（OR=15.851，95% CI: 12.525~20.060）、4.455倍（OR=4.455，95% CI: 3.274~6.062）、1.872倍（OR=1.872，95% CI: 1.452~2.413）；在不同职业中，女性医务人员健康素养水平高于公务员/教师及其他事业单位的女性人员62.7%（OR=0.373，95% CI: 0.252~0.553），且比女性农民的健康素养水平高63.2%（OR=0.368，95% CI: 0.231~0.585）；未婚女性健康素养水平高于在婚女性45.5%（OR=0.545，95% CI: 0.332~0.896）。详见表3。
3　讨论
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研究显示，2018—2023年南昌市女性健康素养水平呈上升趋势，从2018年的17.87%提升到2023年的30.80%，尤其是2019年增幅最大，这得益于《健康中国行动（2019—2030 年）》出台[3] ，为提高妇女健康素养水平提供了政策支持和保障。但是，南昌市女性健康素养水平与同时期的浙江[4]、杭州[5]、沈阳[6]等省市有较大差距。
2018—2023年，南昌市女性健康素养三个方面均呈上升趋势，健康生活方式与行为素养提升幅度最大，健康技能最小，两者均低于基本知识和理念素养，该结果与何晓燕[5]、唐红艳[7]等的研究结果相似。健康素养六个维度均呈上升趋势，其中慢性病防治素养于2019年出现较大幅度的提升，这可能与《健康中国行动（2019—2030 年）》出台[3]有关，传染病防治素养和基本医疗于2020年出现较大幅度的提升，这可能与新冠疫情的发生和《深化医药卫生体制改革2020年下半年重点工作任务》[8]实施有关；六个维度健康素养水平从低到高的排序每年相同，依次为基本医疗、传染病防治、慢性病防治、健康信息、科学健康观和安全与急救，该结果与2022年全国居民健康素养监测情况[9]和张龙[10]、姚丁铭[4]、何晓燕[5]等的研究一致。提示要以基本医疗、传染病和慢性病防治素养为重点，广泛倡导健康生活方式与行为，普及健康技能。
国内不同学者发现，影响女性健康素养的因素多样，涉及城乡、地区、年龄、文化程度、职业和家庭收入等[11-13]，本研究多因素logistic回归分析表明，影响南昌市女性健康素养的因素有城乡、年龄、文化程度、职业和婚姻状况。城乡居住地是南昌市女性健康素养的影响因素与林本翔[12]、陆一鸣[13]的结果一致，本探究数据显示农村女性健康素养提升幅度高于城市，这可能与该市乡村振兴、脱贫乡村健康促进、“送卫生乡下 护百姓健康”等系列政策和活动有关，表明农村政策和活动在健康素养提升方面产生了积极影响。若只考虑年龄，25～34岁组最高，35～69岁女性健康素养水平随着年龄的增大而降低；但在调整了城乡、文化程度、职业、婚姻、经济收入后，25～34岁组与15～24岁组没有显著差异，35～44岁组最高，55～69岁组虽偏低但高于15～24岁组，与单因素分析结果不完全一致，该现象与李莉等[11]的研究结果类似，可能是因年龄增加而积累的健康相关经验对健康素养有一定影响。但55岁以上女性是慢性病的高发对象，黄美[14]研究发现提升健康素养水平对慢性病患者自我管理和生存质量有促进作用，因此要加强55岁以上女性健康素养干预。女性健康素养水平随文化程度的提升而上升，这与李莉[11]、林本翔[12]、陆一鸣[13]等的研究结果一致，其原因在于文化程度的高低直接决定了居民获取并运用健康信息的能力，说明对低文化人群开展健康干预时应通俗易懂化。在不同职业女性中，医务人员的健康素养最高，农民最低，这与陆一鸣[13]、张海容[15]的研究结果一致，这可能与其职业环境有关，医务人员和农民健康素养出现明显提升可能与该市“健康南昌 医者先行”系列活动及上述农村政策和活动相关。未婚女性健康素养水平高于在婚女性，这可能是因为未婚女性无需为家庭生活分担过多精力，从而有更多时间和精力投入到自我保健和健康管理中。不同收入的女性健康素养水平存在差异，且收入水平越高健康素养水平越高，这与王龙娟[16]的结果相同，这可能是因为收入水平较高的女性通常拥有更好的医疗资源和健康服务的获取能力，具备更高水平的健康知识和教育背景，能够更积极地采取健康行为，同时拥有更强大的社会支持网络。
综上所述，在大力贯彻执行《中国妇女发展纲要（2021—2030年）》的基础上，要以传染病和慢性病防治、基本医疗素养为重点内容，以农民、老年、低文化程度和低收入女性为重点人群，创新开展有针对性的健康教育和健康促进活动，广泛倡导健康生活方式与行为，普及健康技能，努力提升女性健康素养水平。
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2024年第51卷第18期
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doi: 10.20043/j.cnki.MPM.202401484
  • 接收时间：2024-01-30
  • 首发时间：2026-03-20
  • 出版时间：2024-09-25
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  • 收稿日期：2024-01-30
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    1.南昌市卫生健康促进中心 江西 南昌 330008
    2.中国疾病预防控制中心控烟办

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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
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