Health literacy and its effect on chronic disease prevention: evidence from China’s data

Background: Improving health literacy is an important public health goal in many countries. Although many studies have suggested that low health literacy has adverse effects on an individual’s health outcomes, confounding factors are often not accounted. This paper examines the interplay between health literacy and chronic disease prevention. Methods: A population-based sample of 8194 participants aged 15–69 years old in Ningbo were used from China’s 2017 National Health Literacy Surveillance Data. We use multivariate regression analysis to disentangle the relationship between health literacy and chronic disease prevention. Results: We find the association between health literacy and the occurrence of the first chronic condition is attenuated after we adjust the results for age and education. This might arise because having one or more chronic conditions is associated with better knowledge about chronic diseases, thus improve their health literacy. More importantly, we find health literacy is associated with a reduction in the likelihood of having a comorbid condition. However, this protective effect is only found among urban residents, suggesting health literacy might be a key factor explaining the rural-urban disparity in health outcomes. Conclusion: Our findings highlight the important role of health literacy in preventing comorbidities instead of preventing the first chronic condition. Moreover, family support could help improve health literacy and result in beneficial effects on health

The economic costs of limited health literacy in China: evidence from China’s National Health Literacy Surveillance data

BACKGROUND: Limited health literacy is a public health challenge contributing to the rising health care costs. We assess the economic costs of limited health literacy in China using data from the National Health Literacy Surveillance survey. METHODS: Our data includes a sample of 6316 residents aged 15–69 years old living in Ningbo, China, in 2019. We use box plots to examine the distribution of out-of-pocket health expenditure by the level of health literacy. We then use the estimates from a two-part model to assess the contribution of limited health literacy to individual medical spending and the aggregate health expenditure at different levels of health literacy for the adult population in Ningbo. RESULTS: Medical costs of limited health literacy are about 10% (177 CNY or about 25 USD) of the annual medical expense of a resident aged 15–69 living in Ningbo. The medical cost of limited health literacy is greater among the rural, female, and older groups than others. If the proportion of people with adequate health literacy increases from 22 to 30% (the target level by 2030), the aggregate out-of-pocket health expenditure in Ningbo will decrease by 100 million CNY (14 million USD), or 0.88% of the 2019 Ningbo government expenditure on health care. CONCLUSIONS: This paper highlights the direct and indirect economic costs associated with limited health literacy. The results should help policymakers evaluate the cost-effectiveness of relevant programs that aim to improve residents’ health literacy. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-022-07795-9

The Community Health Supporting Environments and Residents’ Health and Well-Being:The Role of Health Literacy

We evaluate the impacts that health supporting environments have on residents’ health and well-being. Using a stratified multi-stage sampling method, we select a sample of 12,360 permanent adult residents aged 15–69, and collect information on their health literacy level, as well as their demographic background and health. This individual level data is then merged with the administrative health supporting environment data. More than two thirds of residents self-reported having good/excellent health, and the percent of adults living in communities with healthy parks, healthy trails, and healthy huts in their community is 23 percent, 43 percent, and 25 percent, respectively. Controlling for a series of confounding factors at the community and individual levels, we find that healthy parks and healthy trails are positively correlated with self-reported health, which increases the probability of self-reporting good health by 2.0 percentage points (p < 0.10) and 6.0 percentage points (p < 0.01), respectively. Access to healthy huts is negatively associated with self-reported health, decreasing the probability of self-reporting good health by 5.0 percentage points (p < 0.01). Health literacy plays a role in moderating the effect of health parks, and a positive effect is more likely to be observed among adults with lower health literacy. Health supporting environments may play a role in reducing the likelihood of undiagnosed diseases and changing residents’ lifestyles, which promotes the health and well-being of residents, especially among those with inadequate health literacy

Intelligent gold nanocluster for effective treatment of malignant tumor via tumor-specific photothermal-chemodynamic therapy with AIE guidance.

Precise and efficient therapy of malignant tumors is always a challenge. Herein, gold nanoclusters co-modified by aggregation-induced-emission (AIE) molecules, copper ion chelator (acylthiourea) and tumor-targeting agent (folic acid) were fabricated to perform AIE-guided and tumor-specific synergistic therapy with great spatio-temporal controllability for the targeted elimination and metastasis inhibition of malignant tumors. During therapy, the functional gold nanoclusters (AuNTF) would rapidly accumulate in the tumor tissue due to the enhanced permeability and retention effect as well as folic acid-mediated tumor targeting, which was followed by endocytosis by tumor cells. After that, the overexpressed copper ions in the tumor cells would trigger the aggregation of these intracellular AuNTF via a chelation process that not only generated the photothermal agent in situ to perform the tumor-specific photothermal therapy damaging the primary tumor, but also led to the copper deficiency of tumor cells to inhibit its metastasis. Moreover, the copper ions were reduced to cuprous ions along with the chelation, which further catalysed the excess H2O2 in the tumor cells to produce cytotoxic reactive oxygen species, resulting in additional chemodynamic therapy for enhanced antitumor efficiency. The aggregation of AuNTF also activated the AIE molecules to present fluorescence, which not only imaged the therapeutic area for real-time monitoring of this tumor-specific synergistic therapy, but also allowed us to perform near-infrared radiation at the correct time point and location to achieve optimal photothermal therapy. Both in vitro and in vivo results revealed the strong tumor elimination, effective metastasis inhibition and high survival rate of tumor-bearing mice after treatment using the AuNTF nanoclusters, indicating that this AIE-guided and tumor-specific synergistic strategy could offer a promising approach for tumor therapy

Health literacy and its effect on chronic disease prevention: evidence from China’s data

Background: Improving health literacy is an important public health goal in many countries. Although many studies have suggested that low health literacy has adverse effects on an individual’s health outcomes, confounding factors are often not accounted. This paper examines the interplay between health literacy and chronic disease prevention. Methods: A population-based sample of 8194 participants aged 15–69 years old in Ningbo were used from China’s 2017 National Health Literacy Surveillance Data. We use multivariate regression analysis to disentangle the relationship between health literacy and chronic disease prevention. Results: We find the association between health literacy and the occurrence of the first chronic condition is attenuated after we adjust the results for age and education. This might arise because having one or more chronic conditions is associated with better knowledge about chronic diseases, thus improve their health literacy. More importantly, we find health literacy is associated with a reduction in the likelihood of having a comorbid condition. However, this protective effect is only found among urban residents, suggesting health literacy might be a key factor explaining the rural-urban disparity in health outcomes. Conclusion: Our findings highlight the important role of health literacy in preventing comorbidities instead of preventing the first chronic condition. Moreover, family support could help improve health literacy and result in beneficial effects on health

Health literacy and its effect on chronic disease prevention: evidences from China's national health literacy surveillance data

Objectives Improving health literacy is an important public health goal in many countries. Although many studies have suggested that low health literacy has adverse effects on an individual’s health outcomes, factors that may be confounding the relationship between health literacy and health outcomes are often not accounted. This paper examines the interplay between health literacy and chronic disease prevention. Methodology A sample of 2,835 residents aged 14-71 years old in Ningbo province of China were selected from China’s National Health Literacy Surveillance Survey in 2017. The multivariate regression analysis is used to untangle the relationship between health literacy and chronic disease prevention. Results We find the association between health literacy and the occurrence of the first chronic condition is attenuated after we adjust the results for age and education. In contrast, we find having one or more chronic conditions leads to better knowledge about chronic diseases and thus improved health literacy on chronic disease prevention. Thus, when a respondent has one chronic disease, health literacy could reduce the incidence of a new chronic condition (comorbidities). However, the protective effect of health literacy is only found among our urban sample, suggesting health literacy might be a key factor explaining the rural-urban disparity in health outcomes. Conclusion Our findings highlight that health literacy plays a more important role in helping individuals preventing comorbidity than preventing their first chronic disease. Moreover, family support could be a potential channel through which health literacy accumulates and results in beneficial effects on health

Design of the Firstâ inâ Class, Highly Potent Irreversible Inhibitor Targeting the Meninâ MLL Proteinâ Protein Interaction

The structureâ based design of Mâ 525 as the firstâ inâ class, highly potent, irreversible smallâ molecule inhibitor of the meninâ MLL interaction is presented. Mâ 525 targets cellular menin protein at subâ nanomolar concentrations and achieves low nanomolar potencies in cell growth inhibition and in the suppression of MLLâ regulated gene expression in MLL leukemia cells. Mâ 525 demonstrates high cellular specificity over nonâ MLL leukemia cells and is more than 30 times more potent than its corresponding reversible inhibitors. Mass spectrometric analysis and coâ crystal structure of Mâ 525 in complex with menin firmly establish its mode of action. A single administration of Mâ 525 effectively suppresses MLLâ regulated gene expression in tumor tissue. An efficient procedure was developed to synthesize Mâ 525. This study demonstrates that irreversible inhibition of menin may be a promising therapeutic strategy for MLL leukemia.Irreversible inhibitor Mâ 525 targets the meninâ MLL interaction. It is demonstrated that irreversible inhibition of menin is a promising therapeutic strategy for the treatment of MLL leukemia and may have advantages over reversible inhibitors.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141532/1/anie201711828.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141532/2/anie201711828-sup-0001-misc_information.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141532/3/anie201711828_am.pd

Design of the Firstâ inâ Class, Highly Potent Irreversible Inhibitor Targeting the Meninâ MLL Proteinâ Protein Interaction

The structureâ based design of Mâ 525 as the firstâ inâ class, highly potent, irreversible smallâ molecule inhibitor of the meninâ MLL interaction is presented. Mâ 525 targets cellular menin protein at subâ nanomolar concentrations and achieves low nanomolar potencies in cell growth inhibition and in the suppression of MLLâ regulated gene expression in MLL leukemia cells. Mâ 525 demonstrates high cellular specificity over nonâ MLL leukemia cells and is more than 30 times more potent than its corresponding reversible inhibitors. Mass spectrometric analysis and coâ crystal structure of Mâ 525 in complex with menin firmly establish its mode of action. A single administration of Mâ 525 effectively suppresses MLLâ regulated gene expression in tumor tissue. An efficient procedure was developed to synthesize Mâ 525. This study demonstrates that irreversible inhibition of menin may be a promising therapeutic strategy for MLL leukemia.Der irreversible Inhibitor Mâ 525 greift an der Meninâ MLLâ Wechselwirkung an. Die irreversible Inhibition von Menin erweist sich als vielversprechende Strategie für die Behandlung von MLLâ Leukämie, mit möglichen Vorteilen gegenüber dem Einsatz reversibler Inhibitoren.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141701/1/ange201711828_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141701/2/ange201711828.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141701/3/ange201711828-sup-0001-misc_information.pd