四川省居民中医药健康文化素养水平对健康公平性调节效应分析  

Analysis of the moderating effect of traditional Chinese medicine health culture literacy on health equity among residents in Sichuan Province

作　　者：张盼 吴斗琼 程刚[1] ZHANG Pan;WU Dou-qiong;CHENG Gang(Sichuan Provincial Center for Disease Control and Prevention,Chengdu,Sichuan 610041,China;不详)

机构地区：[1]四川省疾病预防控制中心,四川成都610041 [2]凉山彝族自治州疾病预防控制中心

出　　处：《现代预防医学》2024年第15期2802-2807,共6页Modern Preventive Medicine

摘　　要：目的了解四川省中医药健康文化素养水平在社会经济地位与健康公平性关系之间的调节作用,为缩小社会经济水平带来的健康不公平问题提供新方法。方法2022年6—10月,采用分层多阶段PPS抽样方法,对四川省14个县区15~69岁常住人口进行《全国中医药健康文化素养调查问卷》调查,问卷主要内容包括人口学特征信息、居民的自评健康状况、收入情况等基本情况以及中医药健康文化素养部分,使用STATA 18软件用集中指数法分析我国卫生资源配置公平性情况;采用SPSS 22.0软件分析调查对象的一般人口学资料、不同人群的健康状况差异,利用PROCESS v4.2进行回归分析,根据交互作用系数判断中医药健康文化素养是否存在调节作用,检验水准α=0.05。结果四川省2022年医疗卫生机构、卫生技术人员、医疗床位配置的集中指数分别为0.05043、0.28240、0.19895;收入水平是健康状况的积极影响因素;收入水平×中医药健康文化素养水平作为交互变量对自评健康状况有调节作用,结果显示调节变量系数为0.234,交互作用系数为-0.049(P均<0.05);采用简单斜率法验证结果显示对于低素养人群而言,居民的收入水平对健康状况起显著调节作用(Effect=0.044,s_(x)=0.013,P=0.001),对于中素养人群而言,居民的收入水平对健康状况起显著调节作用(Effect=0.025,s_(x)=0.009,P=0.008),对于高素养人群而言,居民的收入水平对健康状况不起显著调节作用(Effect=0.006,s_(x)=0.012,P=0.645)。结论我省的健康不平等现象仍然比较突出,但中医药健康文化素养水平可以减弱社会经济地位对健康状况的影响,缩小不同人群之间的健康差距,因此,制定提高中医药健康文化素养水平的政策是有必要的。Objective To investigate the moderating effect of the level of traditional Chinese medicine(TCM)health culture literacy in Sichuan Province on the relationship between socioeconomic status and health equity,and to provide new methods for addressing health inequities because of socioeconomic disparities.Methods From June to October 2022,a multi-stage stratified probability proportionate to size sampling(PPS)method was used to conduct a survey using the“National Traditional Chinese Medicine Health Culture Literacy Survey Questionnaire”among residents aged 15 to 69 in 14 counties and districts in Sichuan Province.The questionnaire included demographic information,self-rated health status,income,and TCM health culture literacy.The concentration index method in Stata 18 software was used to analyze the fairness of health resource allocation in China.SPSS 22.0 software was used to analyze the general demographic data of the survey subjects and differences in health status among different groups.Regression analysis was conducted using PROCESS v4.2 to determine whether TCM health culture literacy had a moderating effect based on the interaction coefficient,with a significance level set atα=0.05.Results In 2022,the concentration indices for medical and health institutions,health technical personnel,and medical bed allocation in Sichuan Province were 0.05043,0.28240,and 0.19895,respectively.Income level was found to be a positive influencing factor of health status.The interaction between income level and TCM health culture literacy had a moderating effect on self-rated health status,with the interaction coefficient of-0.049(P<0.05).The simple slope test showed that for individuals with low literacy,income level significantly moderated health status(Effect=0.044,s_(x)=0.013,P=0.001);for those with moderate literacy,income level significantly moderated health status(Effect=0.025,s_(x)=0.009,P=0.008);and for those with high literacy,income level did not significantly moderate health status(Effect=0.006,s_(x)=0.012,P=0.6

关 键 词：中医药健康文化 健康公平 调节效应 

分 类 号：R197.1[医药卫生—卫生事业管理]