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目的分析居民自报健康、真实健康和健康态度之间的潜在关系,解决自报健康跨人群不可比性问题,实现人群健康的综合评价。方法利用2007年中国居民自报健康抽样调查数据,将健康情景评价作为对健康态度的测量,应用结构方程模型的方法,构建自报健康、真实健康和健康态度之间相互关系的理论模型。结果居民自报健康结果除了受真实健康因子的支配外,还受个人健康态度的影响。调整健康态度的影响后,年龄、性别、文化程度、城乡、中部和西部、经济状况等因素的标准化回归系数分别为-0.0765(t=-6.3349),0.0211(t=2.8827),-0.0014(t=-0.7853),0.0275(t=2.5759),0.0491(t=5.4676),-0.0092(t=-0.7778),0.0701(t=7.7376);而真实健康因子与年龄、性别、城乡、经济状况的标准化回归系数则分别为-0.2360(t=-12.3360),0.0016(t=0.0551),0.1269(t=8.3125),0.0421(t=4.0852),-0.0508(t=-4.3965),-0.1653(t=-10.1801),0.0760(t=7.2493)。结论结构方程模型可以应用于人群自报健康状况资料的分析,消除健康态度的影响后获得真实健康因子,后者比自报健康本身更具有可比性,从而客观评价不同人群真实健康状况。
Objective To analyze the potential relationship between residents’ self-reported health, true health and health attitude, and to solve the problem of self-reported incomparability of health across populations and achieve a comprehensive evaluation of the health of the population. Methods According to the health survey data collected from Chinese residents in 2007, the health situation evaluation was taken as a measure of health attitude and the structural model was used to build a theoretical model to describe the interrelationship between health, true health and healthy attitude. Results Residents reported that their health outcomes were influenced by their personal health attitude as well as being controlled by real health factors. After adjusting for the influence of health attitude, the standardized regression coefficients of age, gender, educational level, urban and rural areas, central and western regions, and economic conditions were -0.0765 (t = -6.3349), 0.0211 (t = 2.8827), -0.0014 = -0.7853), 0.0275 (t = 2.5759), 0.0491 (t = 5.4676), -0.0092 (t = -0.7778) and 0.0701 (t = 7.7376) respectively. The correlation between real health factors and age, gender, urban and rural areas, The regression coefficients were -0.2360 (t = -12.3360), 0.0016 (t = 0.0551), 0.1269 (t = 8.3125), 0.0421 (t = 4.0852), -0.0508 (t = -4.3965) 10.1801), 0.0760 (t = 7.2493). Conclusion The structural equation model can be applied to the analysis of health status data of self-reported population. After eliminating the influence of health attitude, the real health factor is obtained. The latter is more comparable than self-reported health itself, so as to objectively evaluate the real health status of different populations.