健康素养作为社会经济因素和健康状况之间的中介因素——以重庆市老年人为例
Health Literacy as a Mediator of the Relationship between Socioeconomic Factors and Health Status—A Study of the Elderly Sample in Chongqing

背景：健康素养被认为是社会经济因素影响健康状况途径的一个潜在中介因子，本研究在一个基于重庆市老年人人群的样本中，探究健康素养是否介导了社会经济因素和健康状况之间的关联。方法：收集2022年重庆市老年人健康素养调查项目的数据，最终纳入5232例数据。以教育水平和经济状况为自变量，健康素养为中介变量，自评健康报告、自我效能和慢性病患病状况为因变量，分别构建中介效应模型，进行中介效应分析。结果：在教育水平和自评健康报告之间的关联路径、教育水平和慢性病患病状况之间的关联路径、经济状况和自评健康报告之间的关联路径、经济状况和慢性病患病状况之间的关联路径中，健康素养分别显著介导了22.56%、42.86%、19.44%和28.77%，为部分中介效应；在教育水平和自我效能之间的关联路径、经济状况和自我效能之间的关联路径中，健康素养为完全中介效应。结论：研究结果表明，健康素养是社会经济因素影响健康状况的一个中介因素，提高不同人群健康素养的政策和干预可能有助于减少健康不平等的问题。
Background: Health literacy is considered to be a potential mediator of socioeconomic factors affecting health status, and this study explored whether health literacy mediated the association between socioeconomic factors and health status in a sample of the elderly population in Chongqing. Methods: The data from the 2022 Chongqing Elderly Health Literacy Survey were collected, and a sample of 5232 cases was finally included. With education level and economic status as independent variables, health literacy as mediating variables, and self-rated health report, self-efficacy and chronic disease conditions as dependent variables, mediating effect models were constructed to analyze the mediating effects. Results: Health literacy significantly mediated 22.56%, 42.86%, 19.44% and 28.77% of the association paths between education level and self-rated health reports, between education level and chronic disease conditions, between economic status and self-rated health reports, and between economic status and chronic disease conditions, which was a partial mediating effect. Health literacy was a complete mediating effect in the association paths between education level and self-efficacy, and between economic status and self-efficacy. Conclusion: The results show that health literacy is a mediating factor of socioeconomic factors affecting health status, and policies and interventions to improve health literacy among different populations may help reduce health inequality.