Abstract
ObjectiveTo investigate the level of and covariates associated with ambient air pollution health literacy (AAPHL) among adult residents of Taiwan.MethodsWith a cross-sectional study design, we conducted telephone interviews using a Chinese version AAPHL scale, which consisted of 24 items assessing 12 subdomains of AAPHL formed by 4 information processing competence matrices (i.e., access, understand, appraise, and apply) and 3 health contexts (i.e., healthcare, disease prevention, and health promotion). The AAPHL was with the lowest and highest score at 1 to 4, respectively. Between September and November 2020, a sample of 1017 and 280 adults was successfully interviewed via home phones and mobile phones, respectively. We employed multiple linear regression models to identify covariates significantly associated with overall and 4 matric-specific AAPHL scores.ResultsThe mean and standard deviation (±SD) of overall AAPHL score was considered as moderate at 2.90 (±0.56), with the highest and lowest metric-specific score for “apply” (3.07 ± 0.59) and “appraise” (2.75 ± 0.66). Lower education was significantly associated with a lower overall score; and living with children < 12 years and single were both significantly associated with higher overall scores. We also noted a significant geographic variation in overall score in which people living in the east/remote islands had highest scores.ConclusionsPeople in Taiwan had only moderate level of AAPHL; and covariates including education, living arrangement, marital status, and area of living were significantly associated with AAPHL. These covariates should be considered in future educational interventions aiming to improve the AAPHL in the community.
Highlights
Ambient air pollution is a major environmental health problem affecting everyone in low, middle, and highincome countries; and representing a considerable threat to health worldwide [1]
We developed the ambient air pollution health literacy (AAPHL) questionnaire on the basis of an existing conceptual framework of health literacy proposed by the European Health Literacy Consortium, which composed of 12 subdomains of health literacy formed by 4 information processing competencies of individuals and 3 health contexts [19]
Because the above-mentioned covariates were reported to be associated with heath literacy, rather than with environmental health literacy (EHL) or with AAPHL, we examined in this study whether these sociodemographic and work characteristics influence the AAPHL level
Summary
Ambient air pollution is a major environmental health problem affecting everyone in low-, middle-, and highincome countries; and representing a considerable threat to health worldwide [1]. According to the 2015 Global Burden of Disease Study [3], exposure to ambient fine particulate matter PM2.5 is the fifth leading cause of death worldwide, accounting for 4.2 million deaths and 103.1 million disability-adjusted life-years in 2015 globally. Epidemiological studies reported links between air pollution and certain diseases of public health importance such as cardiovascular diseases, cancers, and respiratory diseases [4]. Estimated in 2014, PM2.5 accounted for 6,282 deaths from ischemic heart disease, stroke, lung cancer, and chronic obstructive pulmonary disease, representing a population attributable mortality fraction of 18.6% associated with the four disease causes [7]
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