Associations between risk perception, spontaneous adaptation behavior to heat waves and heatstroke in Guangdong province, China.

BACKGROUND: In many parts of the world, including in China, extreme heat events or heat waves are likely to increase in intensity, frequency, and duration in light of climate change in the next decades. Risk perception and adaptation behaviors are two important components in reducing the health impacts of heat waves, but little is known about their relationships in China. This study aimed to examine the associations between risk perception to heat waves, adaptation behaviors, and heatstroke among the public in Guangdong province, China. METHODS: A total of 2,183 adult participants were selected using a four-stage sampling method in Guangdong province. From September to November of 2010 each subject was interviewed at home by a well-trained investigator using a structured questionnaire. The information collected included socio-demographic characteristics, risk perception and spontaneous adaptation behaviors during heat wave periods, and heatstroke experience in the last year. Chi-square tests and unconditional logistic regression models were employed to analyze the data. RESULTS: This study found that 14.8%, 65.3% and 19.9% of participants perceived heat waves as a low, moderate or high health risk, respectively. About 99.1% participants employed at least one spontaneous adaptation behavior, and 26.2%, 51.2% and 22.6% respondents employed <4, 4-7, and >7 adaptation behaviors during heat waves, respectively. Individuals with moderate (OR=2.93, 95% CI: 1.38-6.22) or high (OR=10.58, 95% CI: 4.74-23.63) risk perception experienced more heatstroke in the past year than others. Drinking more water and wearing light clothes in urban areas, while decreasing activity as well as wearing light clothes in rural areas were negatively associated with heatstroke. Individuals with high risk perception and employing <4 adaptation behaviors during heat waves had the highest risks of heatstroke (OR=47.46, 95% CI: 12.82-175.73). CONCLUSIONS: There is a large room for improving health risk perception and adaptation capacity to heat waves among the public of Guangdong province. People with higher risk perception and fewer adaptation behaviors during heat waves may be more vulnerable to heat waves.

[Investigation on the perception of risk level of heat wave and its related factors in Guangdong province].

OBJECTIVE: To investigate the risk perception of heat wave, and further explore its related factors in Guangdong province. METHODS: A total of 2183 adults were selected by a multi-stage sampling method in Guangdong province. Each subject was interviewed in their home with a structured questionnaire by a well trained investigator from September to November, 2010. The questionnaire contained socio-demographic characteristics, heat wave related knowledge, risk perception of heat wave, etc. Chi-square test and multivariate logistic regression were employed in this study. RESULTS: The average age of total 2183 participants was (39.31 ± 14.16) years, among which 53.37% (1165/2183) were males, and 48.74% (1064/2183) were selected from urban. About 38.11% (832/2183) of participants heard about heat wave, and 38.52% (841/2183) of subjects thought the heat wave had higher impact on their health (risk perception score of heat wave ≥ 5 points). About 81.91% (1788/2183) of all participants thought the weather in most recent years was hotter than several years ago. Among these people, 30.48% (545/1788) thought the main reason of weather becoming hotter was due to emission of carbon dioxide, and 26.51% (474/1788) thought it was due to air pollution. Results from the multivariate logistic regression showed that the risk perception score of heat wave were higher in subjects with higher education (OR = 2.16, 95%CI: 1.41 - 3.30), from urban(OR = 1.37, 95%CI: 1.10 - 1.72), with higher score of trust(OR = 1.08, 95%CI: 1.01 - 1.14) and participants with higher score of heat wave related knowledge (OR = 1.39, 95%CI: 1.27 - 1.52). Furthermore, compared to hierarchist, egalitarian (OR = 1.73, 95%CI: 1.30 - 2.29), individualist (OR = 1.93, 95%CI: 1.41 - 2.65) and fatalist (OR = 1.80, 95%CI: 1.41 - 2.29) also had higher risk perception score of heat wave. CONCLUSION: There is a lack of knowledge and risk perception to heat wave among the residents in Guangdong province. Risk perception of heat wave was higher in people who were from urban, had higher level of trust on government, experts and media, had higher health-related knowledge score, and non-hierarchists.

[Association between distorted weight perception and suicide ideation among normal weight adolescents].

OBJECTIVE: To explore the relationship between distorted weight perception and suicide ideation among normal weight adolescents in Guangdong province. METHODS: This study used the data of Guangdong Provincial Youth Health Risk Behavior Survey in 2004 and 2007. To identify the association between distorted weight perception and suicide ideation, a logistic regression analysis was performed. The effects of age, economic status, mother's education, mental health, and depression were also adjusted. RESULTS: A total of 12 729 people participated in this study, 6096 males and 6633 females. The prevalence of suicide ideation among normal weight adolescents was 13.58% (1729/12 729) in the past 12 months, with higher prevalence in girls (16.15%, 1071/6633) than that in boys (10.79%, 658/6096) (χ(2) = 77.71, P = 0.00). It was common that the adolescents misperceived their weight. Only 44.93% (5719/12 729) of normal weight students correctly perceived their body weight while 43.52% (5540/12 729) of them overestimated their weight and 11.43% (1455/12 729) underestimated their weight. The distorted weight perception in girls (65.58%, 4350/6633) was higher than that in boys (43.39%, 2645/6096) (χ(2) = 993.91, P = 0.00). Distorted weight perception was significantly associated with suicide ideation after controlling for factors age, economic status, mother's education, mental health, and depression. The students who overestimate their body weight were more likely to have suicide ideation than that who correctly perceived their weight (OR = 1.43, 95%CI: 1.27 - 1.61). CONCLUSION: The prevalence of distorted weight perception was high and it significantly associated with suicide ideation.

[Study on health-related behaviors among males in rural and urban residents from Guangdong province].

OBJECTIVE: To compare the magnitude of inequities in health-related behaviors among males in Guangdong province, and to investigate the extent of the disparities. METHODS: Data sets available from the Guangdong Chronic Diseases and Risk Factors Survey 2007 are used. Concentration index (C) and concentration curve are employed to measure the differential of males' health-related behaviors across urban and rural areas in Guangdong. Odds ratios of 6 health-related behaviors among different areas are derived from 4 logistic models, after adjusting for age, married state, educational status, occupation and income. RESULTS: Results from Cs reveal that the inequality gradients disadvantageous to men in rural areas are:smoking (C = -0.075, P = 0.000), alcohol intake (C = -0.023, P = 0.002), blood pressure (C = 0.106, P = 0.000), blood sugar (C = 0.114, P = 0.000) and weight (C = 0.107, P = 0.000), while lack of physical activity (C = 0.044, P = 0.000)concentrates in the more affluent areas. The magnitudes of these inequalities appear to be higher on health-seeking behaviors than on health-risk behaviors. After adjusting for age and marital status, there is still strong evidence showing the rural-urban differences in the health related behaviors among males in Guangdong province. When educational status, occupation and income are added to the logistic model as control factors, the results have led to a loss of statistical significance on such rural-urban inequalities, indicating that socioeconomic factors play an important role on these health-related behaviors which leads to the inequalities among males in Guangdong province. CONCLUSION: To reduce the gaps in health-related behaviors seen in the rural and urban areas, effective policies should be developed to change the social determinants of rural-urban differences in health and to strengthen the implementation of health-related programs on those vulnerable groups.