Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, China.
Research Center for Social Risk Governance for Major Public Health Events, Nanjing Medical University, Nanjing, China.
Front Public Health. 2022 Nov 14;10:1022689. doi: 10.3389/fpubh.2022.1022689. eCollection 2022.
To investigate the gender-specific associations between exposure to urbanization and psychological stress in China experiencing rapid urbanization.
Data were obtained from the 2015 China Health and Nutrition Survey. A total of 4,388 men and 5,098 women aged at least 18 years were obtained from 288 communities across 12 provinces and municipalities. Tertiles of the urbanization index, summarizing 12 urbanization dimensions at the community level, were used to define low, medium, and high levels of urbanization. The psychological stress was measured based on the 10-item Perceived Stress Scale. The gender-stratified multilevel analysis (Level-1: Individuals, Level-2: Communities, and Level-3: provinces/municipalities) was used to estimate the association between exposure to urbanization and psychological stress.
After controlling for age, education status, marital status, work status, household income per capita, current smoking, alcohol drinking, sleep duration, BMI, and chronic conditions, the urbanization index was negatively associated with psychological stress in women ( = 0.017) but not men ( = 0.476). More specifically, a one-standard deviation increase in the score of community population density (β = -0.329, = 0.329), modern markets (β = -0.247, = 0.044), education (β = -0.448, = 0.002), and housing (β = -0.380, = 0.005) was negatively associated with psychological stress only in women, separately.
Our data revealed that living in the most urbanized communities is associated with lower levels of psychological stress for women but not men. Thus, this study can help empower decision-makers to accurately target vulnerable communities and plan effective strategies to address psychological outcomes.
在中国快速城市化的背景下，探讨城市化与心理压力之间的性别特异性关联。
数据来自 2015 年中国健康与营养调查。共纳入来自全国 12 个省、直辖市的 288 个社区，年龄至少为 18 岁的男性 4388 人，女性 5098 人。采用城市化指数的三分位数（社区层面的 12 个城市化维度的总和）来定义低、中、高水平的城市化。心理压力基于 10 项感知压力量表来衡量。采用多水平分析（个体水平：个体，社区水平：社区，省级/市级水平：省级/市级）来估计城市化暴露与心理压力之间的关联。
在校正年龄、教育程度、婚姻状况、工作状况、人均家庭收入、当前吸烟、饮酒、睡眠时间、BMI 和慢性疾病等因素后，城市化指数与女性的心理压力呈负相关（β=0.017），但与男性无关（β=0.476）。更具体地说，社区人口密度（β=-0.329，β=0.329）、现代市场（β=-0.247，β=0.044）、教育（β=-0.448，β=0.002）和住房（β=-0.380，β=0.005）的得分每增加一个标准差，仅与女性的心理压力呈负相关，而与男性无关。
本研究数据表明，居住在最城市化的社区与女性的低水平心理压力有关，而与男性无关。因此，本研究可以帮助决策者更准确地针对弱势群体社区，并制定有效的策略来解决心理问题。
