Chen Jinsong, Jiang Shuhan, Pang Mingli, Zhou Huan, Zhang Weifang
School of Law, Hangzhou City University, Hangzhou, China.
School of Humanities and Management, Zhejiang Chinese Medical University, NO.548 Binwen Rd, Binjiang District, Hangzhou, 310053, China, 86 15606860005.
JMIR Public Health Surveill. 2025 Aug 14;11:e72094. doi: 10.2196/72094.
The prevalence of stress factors in urban settings has increased, with significant potential impact on health outcomes.
This study aimed to explore the effect of perceived unfairness, uncertainty, and life stress on self-reported health status, short-term illness, and noncommunicable chronic diseases (NCDs).
A cross-sectional study using multistage stratified sampling was carried out in Xi'an, Hangzhou, Guangzhou, and Guiyang in China in July 2021, and 2851 participants were included in data analysis. Self-reported health status, short-term illness, and NCDs were assessed using self-administered questionnaires. Perceived life stress, unfairness stress, and uncertainty stress were measured using a standard scale. Descriptive statistics were used to analyze participants' demographic characteristics, and chi-square tests clarified statistical differences in self-reported health status, short-term illness, and NCDs based on these characteristics. Multiple logistic regression models were constructed to measure the effects of perceived unfairness stress, uncertainty stress, and life stress on self-reported health status, short-term illness, and NCDs.
Severe uncertainty stress (odds ratio [OR] 1.230, 95% CI 1.007-1.503) and severe life stress (OR 1.728, 95% CI 1.411-2.118) were associated with a higher likelihood of poor self-reported health status. Severe uncertainty stress (OR 1.565, 95% CI 1.270-1.929) and severe life stress (OR 1.404, 95% CI 1.136-1.731) increased the odds of short-term illness. In addition, severe unfairness stress (OR 1.306, 95% CI 1.053-1.620), severe uncertainty stress (OR 1.542, 95% CI 1.248-1.905), and severe life stress (OR 1.344, 95% CI 1.084-1.667) were linked to a higher prevalence of NCDs.
To conclude, severe uncertainty and life stress were both associated with increased odds of poor health outcomes (self-reported health status, short-term illness, and NCDs), while severe unfairness only affected NCDs. The findings of this study may serve as an empirical reference for the improvement of self-reported illness among Chinese urban residents.
城市环境中压力因素的患病率有所上升，对健康结果具有重大潜在影响。
本研究旨在探讨感知到的不公平、不确定性和生活压力对自我报告的健康状况、短期疾病和非传染性慢性病（NCDs）的影响。
2021年7月在中国西安、杭州、广州和贵阳采用多阶段分层抽样进行了一项横断面研究，2851名参与者纳入数据分析。使用自填问卷评估自我报告的健康状况、短期疾病和非传染性慢性病。使用标准量表测量感知到的生活压力、不公平压力和不确定性压力。描述性统计用于分析参与者的人口统计学特征，卡方检验阐明基于这些特征的自我报告健康状况、短期疾病和非传染性慢性病的统计差异。构建多元逻辑回归模型来衡量感知到的不公平压力、不确定性压力和生活压力对自我报告健康状况、短期疾病和非传染性慢性病的影响。
严重的不确定性压力（比值比[OR]1.230，95%可信区间1.007 - 1.503）和严重的生活压力（OR 1.728，95%可信区间1.411 - 2.118）与自我报告健康状况较差的可能性较高相关。严重的不确定性压力（OR 1.565，95%可信区间1.270 - 1.929）和严重的生活压力（OR 1.404，95%可信区间1.136 - 1.731）增加了短期疾病的几率。此外，严重的不公平压力（OR 1.306，95%可信区间1.053 - 1.620）、严重的不确定性压力（OR 1.542，95%可信区间1.248 - 1.905）和严重的生活压力（OR 1.344，95%可信区间1.084 - 1.667）与非传染性慢性病的较高患病率相关。
总之，严重的不确定性和生活压力均与健康结果较差（自我报告健康状况、短期疾病和非传染性慢性病）的几率增加相关，而严重的不公平仅影响非传染性慢性病。本研究结果可为改善中国城市居民自我报告疾病情况提供实证参考。
