Zheng Juan, Li Quan, Wang Jian, Zhang Guojie, Wangen Knut R
a Department of Health Service Management , School of Public Health, Xuzhou Medical University , Xuzhou , Jiangsu , China.
b Center for Health Economic Experiments and Public Policy , School of Public Health, Shandong University , Jinan , Shandong , China.
Hum Vaccin Immunother. 2017 May 4;13(5):1005-1013. doi: 10.1080/21645515.2016.1265714. Epub 2017 Feb 14.
The hepatitis B (HB) awareness level is an important factor affecting the rates of HB virus vaccination. To better understand income-related inequalities in the HB awareness level, it is imperative to identify the sources of inequalities and assess the contribution rates of these influential factors. This study analyzed the unequal distribution of the HB awareness level and the contributions of various influential factors. We performed a cross-sectional household survey with questionnaire-based, face-to-face interviews in 7 Chinese provinces. Responses from 7271 respondents were used in this analysis. Multinomial logistic regression was used for the analysis of contributing factors, and the concentration index was used as a measure of HB awareness inequalities. The HB awareness level varied across participants with different characteristics. Multinomial logistic regression of the explanatory factors of the HB awareness level showed that several estimated coefficients and relative risk ratios were statistically significant for middle- and high-level awareness, except for sex, occupation, and household income. The concentration index of the HB knowledge score was 0.140, indicating inequality gradients disadvantageous to the poor. The contribution rate of socioeconomic factors was the largest (60.8%), followed by demographic characteristics (29.0%) and geographic factors (4.3%). Demographic, socioeconomic, and geographic factors are associated with the HB awareness inequality. Therefore, to reduce inequality, HB-related health education targeting individuals with low socioeconomic status should be performed. Less-developed provinces, especially with high proportions of poor residents, warrant particular attention. Our findings may be beneficial to improve the HB virus vaccination rate for individuals with low socioeconomic status.
乙肝（HB）知晓水平是影响乙肝病毒疫苗接种率的一个重要因素。为了更好地理解乙肝知晓水平方面与收入相关的不平等现象，识别不平等的来源并评估这些影响因素的贡献率至关重要。本研究分析了乙肝知晓水平的不平等分布以及各种影响因素的贡献。我们在中国7个省份开展了一项基于问卷调查的面对面访谈的横断面家庭调查。本分析采用了7271名受访者的回答。多项逻辑回归用于分析影响因素，集中指数被用作衡量乙肝知晓不平等的指标。乙肝知晓水平在具有不同特征的参与者中有所不同。对乙肝知晓水平解释因素的多项逻辑回归显示，除性别、职业和家庭收入外，几个估计系数和相对风险比对于中高水平知晓具有统计学意义。乙肝知识得分的集中指数为0.140，表明存在不利于穷人的不平等梯度。社会经济因素的贡献率最大（60.8%），其次是人口特征（29.0%）和地理因素（4.3%）。人口、社会经济和地理因素与乙肝知晓不平等相关。因此，为了减少不平等，应针对社会经济地位较低的个体开展与乙肝相关的健康教育。欠发达省份，尤其是贫困居民比例较高的省份，值得特别关注。我们的研究结果可能有助于提高社会经济地位较低个体的乙肝病毒疫苗接种率。
