Hu Anning, Yang, X. Y. (2018): Is college education an equalizer for social disparities in health literacy? A case study in Shanghai, China. Global Health Promotion, doi:10.1177/1757975917731576
Objectives: The aim of the study was to illustrate the immediate effect of the college education process (across college grades) on the strength of association between parental education and college attendees’ health literacy.
Methods: Cross-sectional analysis was conducted based on data from a random sample of students in one university in Shanghai, China (N = 574). Exploratory factor analysis was used to generate factors of different dimensions of health literacy. Ordinary least square regression models were estimated to investigate how college education process alters the family-based disparity in health literacy.
Results: The link between parental education and health-related skills did not vary significantly across grades of participants, but participants in their third (p < 0.05) and fourth year (p < 0.001) revealed a significantly weaker association between health-promoting proactivity and parental education, relative to the first-year counterparts. Also, the impact of parental education on health-related attitudes significantly declined among the fourth-year seniors, compared with first-year students (p < 0.05).
Conclusions: Higher education experience is an important mechanism to alleviate the socioeconomic gap in health literacy. Such an equalizer effect, nevertheless, is contingent on the particular dimensions of health literacy.
Methods: Cross-sectional analysis was conducted based on data from a random sample of students in one university in Shanghai, China (N = 574). Exploratory factor analysis was used to generate factors of different dimensions of health literacy. Ordinary least square regression models were estimated to investigate how college education process alters the family-based disparity in health literacy.
Results: The link between parental education and health-related skills did not vary significantly across grades of participants, but participants in their third (p < 0.05) and fourth year (p < 0.001) revealed a significantly weaker association between health-promoting proactivity and parental education, relative to the first-year counterparts. Also, the impact of parental education on health-related attitudes significantly declined among the fourth-year seniors, compared with first-year students (p < 0.05).
Conclusions: Higher education experience is an important mechanism to alleviate the socioeconomic gap in health literacy. Such an equalizer effect, nevertheless, is contingent on the particular dimensions of health literacy.
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Yang XY, Yang T, Nie F (2018): Air pollution as a catalyst for supporting tobacco control policies? Evidence from a nationwide study on Chinese medical students. Tobacco Control 27 (5), 505-512
Purpose Few studies have discussed how the increasing ambient air pollution may affect policy-related attitudes. Medical professionals constitute an important interest group who analyse and solve public issues within a medicalised framework. The current study investigates whether ambient air pollution is associated with a greater likelihood of supporting tobacco control measures among medical students.
Methods We conducted multistage sampling among the medical students from 42 cities in China. We employed propensity-score matching to eliminate the selection bias and used multilevel logistic regressions for the main analysis (n1=9458, n2=42).
Results we found that city-level air particulate matter is consistently associated with the support for tobacco control among medical students, net of other individual-level and city-level covariates. For one standard increase in air particulate matter, people are 1.21 times more likely to fully support tobacco control measures (p<0.05). This association is significantly stronger among medical students who are financially worse-off and are ethnic majority.
Conclusions Environmental pollution has a significant correlation with people’s attitudes towards health policies, even when such policies are not directly concerned with the natural environment. Policy makers may use this opportunity to implement tobacco control measures against the backdrop of China’s pollution crisis.
Online appendix for propensity matching
Methods We conducted multistage sampling among the medical students from 42 cities in China. We employed propensity-score matching to eliminate the selection bias and used multilevel logistic regressions for the main analysis (n1=9458, n2=42).
Results we found that city-level air particulate matter is consistently associated with the support for tobacco control among medical students, net of other individual-level and city-level covariates. For one standard increase in air particulate matter, people are 1.21 times more likely to fully support tobacco control measures (p<0.05). This association is significantly stronger among medical students who are financially worse-off and are ethnic majority.
Conclusions Environmental pollution has a significant correlation with people’s attitudes towards health policies, even when such policies are not directly concerned with the natural environment. Policy makers may use this opportunity to implement tobacco control measures against the backdrop of China’s pollution crisis.
Online appendix for propensity matching
Yang, T., Barnett, R., Rockett, I. R. H., Yang, X. Y., Wu, D., Zheng, W., & Li, L. (2015). The impact of regional economic reliance on the tobacco industry on current smoking in China. Health & Place, 33(0), 159-171
The purpose of this study was to conduct a preliminary assessment of province of residence and other contextual factors on the likelihood of being a current smoker in China. A cross-sectional, multistage sampling process was used to recruit participants, and their smoking status and sociodemographic characteristics were obtained through face-to-face interviews. The contextual variables were retrieved from a national database. Multilevel logistic regression analysis was performed to assess the impact of provincial economic reliance on the tobacco industry, as well as individual-level characteristics, on the likelihood of being a current smoker. Participants totaled 20,601 from 27 cities located in 26 of the 31 municipalities/provinces in China. Overall smoking prevalence was 31.3% (95% CI: 19.3–33.2%), with rates being highest in Yinchuan City in Ningxia Province (49.8%) and lowest in Shanghai (21.6%). The multilevel analysis showed an excess likelihood of being a current smoker for individuals living in provinces with the highest rate of cigarette production relative to those with the smallest (p<0.001). Findings underscore the importance of restricting cigarette production and regulating the marketing of tobacco products in China.
Yang, X.Y., Anderson, J.G., Yang, T. (2014): Impact of Role Models and Policy Exposure on Support for Tobacco Control Policies in Hangzhou, China. American Journal of Health Behavior. 38(2):275-283
Objectives: To examine how expectations of role models concerning smoking and exposure to tobacco control policies are associated with people's support for smoking bans. Methods: Face-to-face interviews were conducted using multistage sampling. Employed structural equation modeling to examine the relationships and multi-group analysis to compare cross-group difference between smokers and non-smokers. Results: Expectations of role models were found to be significantly associated with support for FCTC policies related to smoking. Policy exposure indirectly relates to policy support. Cross-group differences between smokers and non-smokers were not significant. Conclusion: Expectations of role models are strong predictors of support for FCTC tobacco control policy among Chinese urban residents; policy exposure is associated with policy support indirectly through the influence of expectations of role models. Policymakers should utilize social roles to promote tobacco control measures.
