Objective: To analyze the trend of the health literacy level of Chinese residents from 2012 to 2023 and predict the health literacy level from 2024 to 2027. Methods: The study collected data on the health literacy surveillance of Chinese residents from 2012 to 2023. The Joinpoint regression model was used to calculate the average annual percent change (AAPC) and analyze the trend. The interrupted time series analysis with Prais-Winsten transformed generalized least squares estimation was employed to investigate the impact of the"Healthy China 2030" policy on residents' health literacy levels. Joinpoint regression, autoregressive integrated moving average model and grey forecasting models were established to select the optimal model for forecasting health literacy levels from 2024 to 2027. Results: The results showed that the health literacy level of Chinese residents increased from 8.80% in 2012 to 29.70% in 2023 (AAPC=11.65%, P<0.05). The health literacy level of urban and rural residents increased from 11.79% and 7.13% in 2012 to 33.25% and 26.23% in 2023, respectively (AAPC=9.57% and 12.60%, both P<0.05). Rural (1.59% per year) saw a lower average annual increase than urban (1.79% per year), widening the urban-rural health literacy gap. All aspects of health literacy, including basic knowledge and concepts, healthy lifestyles and behaviors, and health skills, showed an upward trend. The literacy level of six health issues-safety and first aid, scientific health views, health information, infectious disease prevention, chronic disease prevention, and basic medical care-also exhibited rising trends. Interrupted time series analysis indicated a significant further increase in the health literacy level of Chinese residents after the implementation of the "Healthy China 2030" policy, with the growth rate increasing from 0.615% per year before implementation to 2.655% per year afterwards. The Joinpoint regression model showed superior predictive performance compared to autoregressive integrated moving average model and grey forecasting models. The prediction results suggested a continued upward trend in the health literacy level from 2024 to 2027, reaching 32.68%, 35.62%, 38.84%, and 42.34%, respectively. Conclusion: From 2012 to 2023, the overall and various aspects of health literacy among Chinese residents show a continuous upward trend. This study predicts that the level of residents' health literacy will continue to rise by 2027.
目的： 了解中国居民2012—2023年健康素养水平趋势并对2024—2027年健康素养水平进行预测。 方法： 收集2012—2023年中国居民健康素养监测数据，采用Joinpoint回归模型计算健康素养年均变化百分比（AAPC）并分析其变动趋势；采用单组中断时间序列中的基于Prais-Winsten变换的广义最小二乘估计拟合模型探索《“健康中国2030”规划纲要》政策实施对居民健康素养水平的影响；建立Joinpoint回归模型，自回归移动平均模型和灰色预测模型，遴选最优模型预测2024—2027年我国居民健康素养水平。 结果： 中国居民健康素养从2012年的8.80%上升至2023年的29.70%（AAPC=11.65%，P<0.05）；其中，城市和农村的健康素养水平分别从2012年的11.79%和7.13%上升至2023年的33.25%和26.23%（AAPC=9.57%，12.60%，均P<0.05），农村（1.59%/年）平均年度上升率低于城市（1.79%/年），城乡健康素养差距扩大。基本知识与理念、健康生活方式和行为及健康技能3个方面素养，安全与急救、科学健康观、健康信息、传染病防治、慢性病防治和基本医疗6类健康问题素养均呈上升趋势。中断时间序列分析结果显示，《“健康中国2030”规划纲要》实施后中国居民健康素养水平进一步显著提升，上升速度从实施前的0.615%/年增长为实施后的2.655%/年。Joinpoint回归模型预测性能明显优于自回归移动平均模型和灰色预测模型，预测结果显示，2024—2027年中国居民健康素养水平预计呈持续上升趋势，将分别达到32.68%、35.62%、38.84%和42.34%。 结论： 2012—2023年中国居民总体及其各方面和各类型健康素养水平均呈上升趋势，预测到2027年居民健康素养水平将持续升高。.