Health information seeking partially mediated the association between socioeconomic status and self-rated health among Hong Kong Chinese

Abstract

Background: Poor self-rated health (SRH) is socially patterned with health communication inequalities, arguably, serving as one mechanisms. This study investigated the effects of health information seeking on SRH, and its mediation effects on disparities in SRH.

Methods: We conducted probability-based telephone surveys administered over telephone in 2009, 2010/11 and 2012 to monitor health information use among 4553 Chinese adults in Hong Kong. Frequency of information seeking from television, radio, newspapers/magazines and Internet was dichotomised as <1 time/month and ≥ 1 time/month. Adjusted odds ratios (aOR) for poor SRH were calculated for health information seeking from different sources and socioeconomic status (education and income). Mediation effects of health information seeking on the association between SES and poor SRH was estimated.

Results: Poor SRH was associated with lower socioeconomic status (P for trend <0.001), and less than monthly health information seeking from newspapers/magazines (aOR = 1.23, 95% CI 1.07-1.42) and Internet (aOR = 1.13, 95% CI 0.98-1.31). Increasing combined frequency of health information seeking from newspapers/magazines and Internet was linearly associated with better SRH (P for trend <0.01). Health information seeking from these two sources contributed 9.2% and 7.9% of the total mediation effects of education and household income on poor SRH, respectively.

Conclusions: Poor SRH was associated with lower socioeconomic status, and infrequent health information seeking from newspapers/magazines and Internet among Hong Kong Chinese. Disparities in SRH may be partially mediated by health information seeking from newspapers/magazines and Internet.

Figure 1. Mediation effects of information seeking from newspapers/magazines and Internet on disparities in poor SRH ^†.

^† All figures are β-coefficients. ***P<0.001. Total effect of educational attainment on poor self-rated health was 17.4% (SE 0.017, 95% CI 14.1%–20.8%); indirect effect of information seeking on self-rated health was 1.6% (SE 0.5%, 95% CI 0.7%–2.6%), which yielded 9.2% of the total effect was mediated through health information seeking from newspapers/magazines and Internet (Sobel test P<0.01). Total effect of household income on poor self-rated health was 16.9% (SE 0.018, 95%CI: 13.7%–20.5%); indirect effect of information seeking on self-rated health was 1.3% (SE 0.3%, 95% CI 0.7%–2.0%), which yielded 7.9% of the total effect was mediated through health information seeking from newspapers/magazines and Internet (Sobel test P<0.01).