Analysis Of Drinking Water Health Risk Perception And Behavior Influencing Factors Of Rural Middle-aged And Elderly Residents In A County In A Province

Objective:Access to adequate,safe and hygienic drinking water is the most basic requirement for a healthy life.Drinking water in China’s rural areas is poor,and middle-aged and elderly residents who have lived in rural areas for a long time have to face risks from drinking water.Drinking water risk,also will certainly affect the drinking water behavior of residents.Drinking water health risk perception plays an important role in influencing water treatment behavior.Based on a structured questionnaire,this study collected drinking water situation and drinking water related perception information of families and individuals of rural permanent middle-aged and elderly residents in a county in a province,to explore the influencing factors of drinking water health risk perception and related behaviors of middle-aged and elderly residents.Based on the results of the study,the health strategy of improving the drinking water status of rural middle-aged and elderly residents is proposed,which provides a new idea for further developing drinking water safety policies for rural residents and promoting the construction of rural drinking water safety projects.Method:A cross-sectional survey was conducted among permanent middle-aged and elderly residents meeting inclusion criteria in 6 townships and rural areas of in a county in a province from July 2021 to September 2021.Social demographic characteristics,household drinking water status,drinking behavior,health status and drinking-related perception of residents were collected through a structured questionnaire.Classification variables were described by frequency and percentage,and normal distribution variables were described by mean and standard deviation.A structural equation model was used to explore the influence relationship between drinking water related perceptions,and the Chi-square test was used to preliminarily analyze the influencing factors of drinking water health risk behavior.The effects of various factors on drinking water health risk behavior were further analyzed by binary Logistics regression.Results:1.Among the 500 respondents,175 residents drank unboiled water,accounting for 35.0%,while 325 did not drink unboiled water,accounting for 65.0%.149 people,or 29.8 percent,said they would use the filter,while 351 people,or 70.2 percent,said they would not.34 people,or 6.8 percent,use bottled water,and 466 people,or 93.2 percent,do not use bottled water.2.The structural equation model showed that the regional environmental perception indirectly affected the perception of health risk through the perception of tap water quality,and the indirect effect was 0.093,which was statistically significant(95%CI=0.020-0.171 and 95%CI=0.018-0.168).The satisfaction of water supply institutions indirectly affected the perception of health risk through the perception of tap water quality,and the indirect effect was-0.639,which was statistically significant(95%CI=-0.757--0.544 and95%CI=-0.749--0.539).3.Among the three behaviors of drinking water health risk perception,drinking unboiled water behavior(r=-0.217,p < 0.01)and filter use intention(r=0.437,p < 0.01)were significantly correlated with drinking water health risk perception.There was no significant correlation between barreled water use behavior(r=-0.005,p > 0.05)and drinking water health risk perception.Univariate analysis of unboiled water drinking behavior showed that There were significant differences in drinking behaviors among middle-aged and elderly residents of different age groups,occupations,education levels,body mass index(BMI),whether to treat water when entering the house,the number of boiling water,whether to drink water voluntarily,whether to think the consequences of drinking untreated unboiled water,whether to suffer from kidney stones,whether there was drinking water knowledge propaganda in the village and whether it was necessary to publicize drinking water knowledge for villagers(p < 0.05).Univariate analysis of filter use intention showed that There were significant differences among middle-aged and elderly residents with different age groups,education level,type of water supply,type of centralized water supply source,whether there would be water shortage,whether it was treated at home,whether it was equipped with water purifier/filter,whether it was stored,thought the consequence of drinking untreated unboiled water,type of toilet and distance to the nearest general hospital(p < 0.05).4.Logistic regression analysis showed that residents aged 70-80 years old(OR=0.448)and 80 years old(OR=0.095)were less likely to drink unboiled water.Those who had a normal BMI(OR=5.406),drank water voluntarily on a daily basis(OR=0.506),believed that unboiled water had no effect on their health(OR=18.074),was good for their health(OR=204.176),and had kidney stones(OR=2.209)were more likely to drink unboiled water.5.Logistic regression analysis showed that residents aged 70-80 years old(OR=0.232)and 80 years old(OR=0.213)who were more than 10 km away from the nearest general hospital(OR=0.582)were more reluctant to use filters.Residents using distributed mixed centralized water supply(OR=2.116),in-home treatment water(OR=7.902),and water purifiers OR filters(OR=38.801)were more likely to use filters.Conclusion:1.In this study,a structural equation model was constructed,which took the perception of tap water quality as the intermediary variable of the model,and had good reliability and validity,and each scale had a stable structure.It is possible to study the factors influencing residents’ subjective perception of drinking water and reduce the gap between subjective drinking water health risks and objective water quality risks.2.The perception of tap water quality is an intermediate variable affecting the perception of health risk,and can directly affect the perception of health risk.The perception of health risks gradually decreases with the deepening of residents’ perception of tap water quality.By reducing the regional environmental perception and improving the satisfaction of water supply agencies,the perception of tap water quality of rural middle-aged and elderly residents can be improved,thus reducing the perception of health risk.3.Unboiled water drinking behavior and filter use intention were significantly correlated with perceived health risks.In the study area,the elderly residents in rural areas had a higher rate of drinking unboiled water and a lower rate of willingness to use filters.We should strengthen the popularization of drinking water health knowledge,improve health literacy,and reduce the rate of drinking unboiled water.At the same time,economical and effective water filters can be popularized at the household level,effective intervention measures can be put forward to promote the safety of drinking water for rural residents,and new ideas and directions can be provided to promote the construction of safe drinking water projects in rural areas.4.The willingness of middle-aged and elderly rural residents to drink unboiled water and use filters is affected by many factors.Basic demographic characteristics,household drinking water status,drinking behavior and health status are all direct factors affecting unboiled water drinking behavior and the intention to use filters.In the intervention of middle-aged and elderly residents drinking unboiled water behavior,attention should be paid to the middle-aged group,low health literacy,drinking behavior habits of poor objects.It is also necessary to increase health literacy among middle-aged and elderly rural residents,improve health literacy,promote cost-effective water filtration facilities,and improve drinking water safety.