School of Public Administration, Guangzhou University, Guangzhou, Guangdong, China.
Department of Primary Public Health, Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong, China.
BMC Public Health. 2019 Feb 21;19(1):221. doi: 10.1186/s12889-019-6538-2.
BACKGROUND: Health literacy and health-information seeking behaviour (HISB) play vital roles in health outcome improvements. This study examines the extent of income-related inequality in health literacy and health-information seeking as well as the contributions of the main socioeconomic determinants in China. METHODS: We analysed representative data of participants aged over 18 years as well as older adults from the Guangzhou Community Health Survey. A concentration index (CI) was used to quantify the degree of income-related inequity in health literacy and health-information seeking. Probit regression models were employed to decompose the CI into the contributions to each factor. RESULTS: Results showed a significant pro-rich distribution of adequate health literacy (CI: 0.0602, P < 0.001; horizontal index [HI]: 0.0562, P < 0.001) and HISB from healthcare professionals (CI: 0.105, P < 0.001; HI: 0.0965, P < 0.001). The pro-rich distribution of health literacy was mainly attributable to education background (contribution: 54.76%), whereas income inequalities contributed most to the pro-rich distribution of health-information seeking among an urban population (contribution: 62.53%). CONCLUSION: Public interventions in China to reduce inequality in health literacy and HISBs among the urban population, coupled with easily accessible information sources on health, warrant further attention from policymakers.
背景:健康素养和健康信息寻求行为(HISB)在改善健康结果方面发挥着重要作用。本研究考察了健康素养和健康信息寻求方面收入相关不平等的程度,以及中国主要社会经济决定因素的贡献。
方法:我们分析了来自广州社区健康调查的 18 岁以上及老年人代表性数据。使用集中指数(CI)来量化健康素养和健康信息寻求方面收入相关不平等的程度。采用 Probit 回归模型将 CI 分解为每个因素的贡献。
结果:结果显示,充足的健康素养(CI:0.0602,P < 0.001;水平指数 [HI]:0.0562,P < 0.001)和向医疗保健专业人员寻求健康信息(CI:0.105,P < 0.001;HI:0.0965,P < 0.001)的分布呈明显的有利于富人的分布。健康素养的有利于富人的分布主要归因于教育背景(贡献:54.76%),而收入不平等对城市人口中有利于富人的健康信息寻求分布的贡献最大(贡献:62.53%)。
结论:中国需要采取公共干预措施,以减少城市人口中健康素养和 HISB 的不平等,同时需要关注容易获取健康信息的来源,这需要政策制定者进一步关注。
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