Health disparities among the western, central and eastern rural regions of China after a decade of health promotion and disease prevention programming / 华中科技大学学报（医学）（英德文版）

Health disparities between the western, central and eastern regions of rural China, and the impact of national health improvement policies and programming were assessed. A total of 400 counties were randomly sampled. ANOVA and Logistic regression modeling were employed to estimate differences in health outcomes and determinants. Significant differences were found between the western, central and eastern rural regions in community infrastructure and health outcomes. From 2000 to 2010, health indicators in rural China were improved significantly, and the infant mortality rate (IMR), maternal mortality rate (MMR) and under 5 mortality rate (U5MR) had fallen by 62.79%, 71.74% and 61.92%, respectively. Central rural China had the greatest decrease in IMR (65.05%); whereas, western rural China had the greatest reduction in MMR (72.99%) but smallest reduction in U5MR (57.36%). Despite these improvements, Logistic regression analysis showed regional differences in key health outcome indicators (odds ratios): IMR (central: 2.13; western: 5.31), U5MR (central: 2.25; western: 5.69), MMR (central: 1.94; western: 3.31), and prevalence of infectious diseases (central: 1.62; western: 3.58). The community infrastructure and health outcomes of the western and central rural regions of China have been improved markedly during the first decade of the 21st century. However, health disparities still exist across the three regions. National efforts to increase per capita income, community empowerment and mobilization, community infrastructure, capacity of rural health facilities, and health literacy would be effective policy options to attain health equity.

Status of household disaster preparedness and affecting factors among the general public of four counties in Shaanxi / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the status of household disaster preparedness in 4 counties of Shaanxi province and explore the affecting factors.</p><p><b>METHODS</b>During the period from September to October in 2008, multi-stage sampling was used to select subjects from urban and rural residents in Xincheng district, Hantai district, Fuping county and Xunyang county of Shaanxi province. Questionnaire survey was conducted among 1945 subjects aged 18-88 years to investigate their experience and expectation of disaster events, preparedness knowledge, activities and emergency supplies. Logistic regression was used to analyze the factors influencing household disaster preparedness.</p><p><b>RESULTS</b>The average age of the 1945 subjects was (43.55 ± 12.76) years old. A total of 7.12% (138/1939) of respondents never experienced disaster. Earthquake and fire (57.35% (1175/2049), 19.81% (406/2049), respectively) were rated as the two disasters most likely to occur. The awareness rate of knowledge about household disaster preparedness was 51.43% (989/1923), and 23.41% (454/1939) discussed how to prepare for disaster with their family, only 9.27% (179/1932) attended evacuation drill. The rates of preparing household emergency supplies were 23.64% (230/973), 30.56% (55/180), 31.19% (141/452) and 54.49% (97/178) for urban residents, subjects with junior college or above education, subjects having frequent family discussions of disaster preparedness and subjects participating in emergency rescue drills, respectively. For subjects with junior high school, senior high school and junior college or higher education, the likelihood of preparing household emergency supplies was 5.02 (95%CI: 1.12 - 22.42), 5.74 (95%CI: 1.27 - 26.04) and 6.84 (95%CI: 1.44 - 32.39) times as that of illiterate, respectively. Urban residents, subjects who often discussed disaster preparedness with their family, and who participated in emergency rescue drills were more likely to prepare emergency supplies than rural residents (OR = 4.38, 95%CI: 2.74 - 7.00), those who never discussed (OR = 4.99, 95%CI: 2.52 - 9.91), and who didn't participate (OR = 5.72, 95%CI: 3.84 - 8.51).</p><p><b>CONCLUSION</b>The residents in 4 counties of Shaanxi lack comprehensive knowledge and appropriate activities of disaster preparedness, the rate of preparing household emergency supplies is low. Higher education, living in urban area, frequent family discussions of disaster preparedness and participating in emergency rescue drills are facilitating factors of preparing household emergency supplies.</p>

Status of knowledge and behavior of drug use among residents in 5 provinces in China in 2011 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To understand the status of knowledge and behavior of drug use among urban and rural residents in 5 provinces in China to suggest priority intervention strategies and measures for drug use health education.</p><p><b>METHODS</b>From March to May of 2011, 6159 urban and rural residents were selected from Beijing, Liaoning, Zhejiang, Yunnan, Shaanxi provinces by the multistage stratified sampling method and were investigated by the questionnaires on drug use knowledge and behavior.</p><p><b>RESULTS</b>The residents' average awareness rate for 11 pieces of basic drug use information was 48.3% (32,750/67,749). The residents' average awareness rate in the rural (40.3%, 9189/22 792) was lower than that in metropolitan (51.9%, 11 483/22 110) and small and middle-sized cities (52.9%, 12,078/22,847) and the differences had statistical significance (χ2=889.30, P<0.01). Overall, 77.0% (4742/6159) of residents purchased drug according to the doctors' prescription; 36.9% (2271/6159) of residents bought by their experiences; 33.3% (2049/6159) of residents did not know whether they had bought faked drugs; 32.7% (2016/6159) of residents did not read instructions carefully before using drug; 83.4% (5134/6159) of residents stored drugs in their house and only 29.2% (1798/6159) of residents would check up expired drugs regularly; 59.6% (3673/6159) of residents changed drug by themselves after suspected adverse reaction of drugs.</p><p><b>CONCLUSION</b>Chinese urban and rural residents' knowledge level of drug use is inadequate and drug use behaviors are not optimistic. Drug use health education should be enhanced among urban and rural residents.</p>

Study on indicator system for evaluating the adult health literacy in China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To establish a comprehensive evaluation indicator system for healthy literacy based on national survey data.</p><p><b>METHOD</b>A multi-stage stratified sampling method was carried out to select the sample population in six provinces of China, which were adults aged 18 - 69 years old. The national health literacy questionnaire was used to investigate the sample populations. The answers were scored according to the error answer of 0, uncertain answer of 1 and the correct answer of 2. The degrees of difficulty and difference were calculated and be used to screen the indicators from the questionnaire as to establishing the comprehensive evaluation indicator system of the health literacy. The Cronbach alpha coefficient, correlation analysis, regression analysis and cluster analysis methods were used to assess the reliability and validity of the indicator system.</p><p><b>RESULTS</b>The samples were 11 759 people, the valid questionnaires were 11 693 and the effective recovery rate was 99.4%, the Myer' index of sample was 4.92. There were 40 indexes selected to establish the comprehensive evaluation indicator system of health literacy. The correlation coefficient between indicator system and the questionnaire scores was 0.948 (P < 0.01), there were the significant differences between groups of being clustered by Q cluster analysis method (P < 0.01). The VIF of these four dimensions was less than 5.</p><p><b>CONCLUSION</b>In this study, the comprehensive evaluation indicator system had a good reliability and validity, and there existed no collinearity among four dimensions of indicator system, it should be the foundation for developing comprehensive evaluation index of health literacy.</p>

Study on health related behaviors and its protective factors of junior middle school students in 4 cities of China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To provide accurate data on health related behaviors and protective factors among students in middle schools in China, for developing priorities, programs and policies on health education.</p><p><b>METHODS</b>We used a standard scientific sample selection process developed by American Center for Disease Control and Prevention (CDC) to conduct the questionnaire survey among middle schools from four cities--Beijing, Hangzhou, Wuhan and Urumchi.</p><p><b>RESULTS</b>Data were found as: 3.2% of students are overweight; 25.3% of students rarely washing hands before eating at school, 20.5% of the students had seriously injured in the past 12 months, 30.4% of male students having had physical fighting, 17.1% of the students having serious attempted suicide, 29.7% of the students ever tried or experimented cigarette smoking, 13.0% having drunk from alcohol and 14.5% having been offered or selling drugs during the past 30 days, 78.9% were in an insufficient amount of physical activity and only 14.3% often used seat belt when riding in a car.</p><p><b>CONCLUSIONS</b>There were many problems on health related behaviors among middle school students in these four cities, especially on hygiene, physical activities, psychological situation, smoking and drinking etc. It is absolutely necessary to develop health education for children and adolescence to promote their healthy behaviors and lifestyle.</p>