Background: This study aimed to evaluate the prevalence of low health literacy in Hebei Province of China, and to investigate its socio-demographic risk factors.Methods: This study was a community-based, cross-sectional questionnaire survey with a multiple-stage randomization design and a sample size of 10560. Participants’ health literacy status was evaluated by a questionnaire based on the 2012 Chinese Resident Health Literacy Scale. Meanwhile, participants’ socio-demographic characteristics were also collected by the questionnaire.Results: A total of 9952 participants provided valid questionnaires and were included in the final analyses. The mean health literacy score was 63.1±17.1 points; for its subscales, the mean basic knowledge and concepts score, lifestyle score, health-related skills score were 31.7±9.0, 17.2±4.8, 14.3±4.1, respectively. Meanwhile, low health literacy prevalence was 81.0%; for its subscales, low basic knowledge and concepts prevalence (70.6%) was numerically reduced compared to low lifestyle prevalence (87.4%) and low health-related skills prevalence (86.1%). Further analyses showed that age, male and rural area were positively associated, but education level and annual household income were negatively associated with low health literacy prevalence. Further multivariate logistic regression analyses showed that higher age, male, lower education level, lower annual household income and rural area were closely correlated with the risks of low total health literacy or low health literacy in subscales in Hebei Province.Conclusion: The prevalence of low health literacy is 81.0% in Hebei Province. Meanwhile, higher age, male, lower education level, lower annual household income and rural area closely associate with low health literacy risk.
Background Young people who have just reached adulthood are prone to adverse reactions during various social adaptations, which can lead to depression. Depressive symptom among young adults is a severe public health burden currently deteriorating in progress. Smoking behavior, exposure to secondhand smoke in household and in various indoor settings may significantly affect depressive symptoms in young adults. Objective The purpose of this study was to evaluate whether recent tobacco smoking, household secondhand smoke exposure and confined space secondhand smoke exposure are associated with depressive symptom in young adults after adjustments for each other. Materials and Methods We extracted data from NHANES 2013–2018, including demographic characteristics, depression level, physical activity, current health status, body measures, recent tobacco smoking, household secondhand smoke exposure and confined space secondhand smoke exposure. A total of 4129 young adults age 18–35 years (mean age 26.11 ± 5.39 years, 2021 males and 2108 females) were included. Depressive symptom was screened by PHQ-9. Recent tobacco smoking and household secondhand smoke exposure were assessed by whether participants had smoked tobacco in the last five days and whether the living with a smoker who smoked inside the house. Confined space secondhand smoke exposure was assessed using the Secondhand Smoke Exposure Questionnaire in this study. We performed binary logistic regression models to analyze the association of recent tobacco smoking, household secondhand smoke exposure, confined space secondhand smoke exposure and depressive symptom, respectively. Results Recent tobacco smoking were positively associated with depressive symptom (OR = 2.201, 95% CI: 1.735–2.353, P < 0.001), this association remained significant after adjusted for confounding variables (OR = 1.593, 95% CI: 1.318–1.926, P < 0.001). Household secondhand smoke exposure was significantly associated with depressive symptom before adjustment for confounding variables (OR = 1.715, 95% CI: 1.479–1.989, P = 0.001), and this association was not statistically significant after adjustments (OR = 1.132, 95% CI: 0.942–1.360, P = 0.108). Confined space secondhand smoke exposure was positively associated with depressive symptom (OR = 1.812, 95% CI: 1.565–2.097, P < 0.001), this association remained significant after adjusted for confounding variables (OR = 1.399, 95% CI: 1.185–1.651, P < 0.001). Among the different settings of confined space secondhand smoke exposure, restaurant exposure (OR = 1.732, 95% CI: 1.120–2.678, P = 0.013) and in-car exposure (OR = 1.350, 95% CI: 1.102–1.652, P = 0.004) were significantly associated with depressive symptom after adjusted for confounding variables. Conclusions Recent tobacco smoking, restaurant and in-car secondhand smoke exposure are associated with greater risk of depressive symptom among U.S. young adults.
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