Prevalence of Suboptimal Health Status and the Relationships between Suboptimal Health Status and Lifestyle Factors among Chinese Adults Using a Multi-Level Generalized Estimating Equation Model

This study examined the prevalence of suboptimal health among Chinese adults based on a large-scale national survey and clarified the relationship between suboptimal health and lifestyle factors. We used multi-level generalized estimating equation models to examine the relationships between suboptimal health and lifestyle factors. Of the 48,978 respondents, 34,021 reported one or more suboptimal health symptoms, giving a suboptimal health status prevalence of 69.46%. After controlling for the cluster effect of living areas and confounding effect of demographic characteristics, factors associated with suboptimal health were: current smoking (odds ratio (OR) = 1.083, 95% confidence interval (CI): 1.055–1.111), drinking alcohol (OR = 1.075, 95% CI: 1.025–1.127), family history of disease (OR = 1.203, 95% CI: 1.055–1.111), sleeping <6 h per day (OR = 1.235, 95% CI: 1.152–1.256), poor sleep quality (OR = 1.594, 95% CI: 1.515–1.676), stress (OR = 1.588, 95% CI: 1.496–1.686), negative life events (OR = 1.114, 95% CI: 1.045–1.187), unhealthy diet choices (OR = 1.093, 95% CI: 1.033–1.156), and not regularly having meals at fixed hours (OR = 1.231, 95% CI: 1.105–1.372). Respondents who exercised regularly had lower odds of having suboptimal health status (OR = 0.913, 95% CI: 0.849–0.983). Suboptimal health has become a serious public health challenge in China. The health status of the population could be effectively improved by improving lifestyle behaviors.

Download Full-text

Prevalence and Associated Lifestyle Factors of Suboptimal Health Status among Chinese Children Using a Multi-Level Model

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17051497 ◽

2020 ◽

Vol 17 (5) ◽

pp. 1497

Author(s):

Tao Xu ◽

Junting Liu ◽

Guangjin Zhu ◽

Shaomei Han

Keyword(s):

Health Status ◽

Lifestyle Factors ◽

Chinese Children ◽

Cluster Effect ◽

Poor Sleep ◽

Lifestyle Behaviors ◽

Confounding Effect ◽

Suboptimal Health Status ◽

Multi Level ◽

Suboptimal Health

Chinese children are facing health challenges brought by chronic non-communicable diseases, such as physical problems and psychological related health problems. Childhood represents a critical life period when the long-term dietary and lifestyle behaviors are formed. It is necessary to survey the prevalence of suboptimal health status (SHS) among Chinese children and to research the relationship between SHS and lifestyles. This study aimed to examine the prevalence of SHS among Chinese children using a large-scale population survey sample covering school students and nonstudent children, and clarified the relationships between SHS and lifestyle factors using multi-level models controlled for the cluster effect of location and the confounding effect of demographics. Multi-level generalized estimating equation models were used to examine the relationships between SHS and lifestyle factors. Prevalence ratios (PR) and 95% confidence intervals (CI) were used to assess the strength of these relationships. Of the 29,560 children, 14,393 reported one or more SHS symptoms, giving a SHS prevalence of 48.69%. The prevalence of SHS for boys (46.07%) was lower than that for girls (51.05%). After controlling for the cluster effect of living areas and confounding effect of demographic characteristics, lifestyle factors associated with SHS were: less sleep duration, current smokers (PR = 1.085, 95%CI: 1.027–1.147), current drinkers (PR = 1.072, 95%CI: 1.016–1.131), children’ parents suffering from chronic diseases (PR = 1.294, 95%CI: 1.179–1.421), poor sleep quality (PR = 1.470, 95%CI: 1.394–1.550), stress (PR = 1.545, 95%CI: 1.398–1.707), negative life events (PR = 1.237, 95%CI: 1.088–1.406), hypertension (PR = 1.046, 95%CI: 1.009–1.084), unhealthy diet choice (PR = 1.091, 95%CI: 1.051–1.133) and irregular meal time (PR = 1.210, 95%CI: 1.163–1.259). Children who could exercise regularly (PR = 0.897, 95%CI: 0.868–0.927) and those with regular medical checkup (PR = 0.891, 95%CI: 0.854–0.929) were associated with lower prevalence probability of SHS. SHS has become a serious public health challenge for Chinese children. Unhealthy lifestyles were closely associated with SHS. Implementation of preventative strategies are needed to reduce the potential SHS burden associated with these widespread high-risk unhealthy lifestyle behaviors.

Download Full-text

Association of lifestyle factors and suboptimal health status: a cross-sectional study of Chinese students

BMJ Open ◽

10.1136/bmjopen-2014-005156 ◽

2014 ◽

Vol 4 (6) ◽

pp. e005156-e005156 ◽

Cited By ~ 31

Author(s):

J. Bi ◽

Y. Huang ◽

Y. Xiao ◽

J. Cheng ◽

F. Li ◽

...

Keyword(s):

Health Status ◽

Chinese Students ◽

Cross Sectional Study ◽

Lifestyle Factors ◽

Sectional Study ◽

Cross Sectional ◽

Suboptimal Health Status ◽

Suboptimal Health

Download Full-text

Association between lifestyle factors and suboptimal health status among Chinese college freshmen: a cross-sectional study

BMC Public Health ◽

10.1186/s12889-017-5002-4 ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 9

Author(s):

Chenjin Ma ◽

Wangli Xu ◽

Long Zhou ◽

Shuangge Ma ◽

Yu Wang

Keyword(s):

Health Status ◽

College Freshmen ◽

Cross Sectional Study ◽

Lifestyle Factors ◽

Sectional Study ◽

Cross Sectional ◽

Suboptimal Health Status ◽

Suboptimal Health

Download Full-text

Associations of environment and lifestyle factors with suboptimal health status: a population-based cross-sectional study in urban China

Globalization and Health ◽

10.1186/s12992-021-00736-x ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Yunlian Xue ◽

Zhuomin Huang ◽

Guihao Liu ◽

Zicheng Zhang ◽

Yefang Feng ◽

...

Keyword(s):

Health Status ◽

Cross Sectional Study ◽

Lifestyle Factors ◽

Lifestyle Behaviors ◽

Sectional Study ◽

Cross Sectional ◽

Environment Factors ◽

Suboptimal Health Status ◽

General Physical ◽

Suboptimal Health

Abstract Introduction Suboptimal health status (SHS), an intermediate state between chronic disease and health, is characterized by chronic fatigue, non-specific pain, headaches, dizziness, anxiety, depression, and functional system disorders with a high prevalence worldwide. Although some lifestyle factors (e.g. smoking, alcohol consumption, physical exercise) and environmental factors (e.g. air quality, noise, living conditions) have already been studied, few studies can comprehensively illustrate the associations of lifestyle and environment factors with general, physical, mental, and social SHS. Methods A cross-sectional study was conducted among 6750 urban residents aged 14 years or over in five random cities from September 2017 to September 2018 through face-to-face questionnaires. There were 5881 valid questionnaires with a response rate of 87%. A general linear model and structural equation model were developed to quantify the effects of lifestyle behaviors and environment factors on SHS. Results The detection rates of general, physical, mental, and social SHS were 66.7, 67.0, 65.5, and 70.0%, respectively. Good lifestyle behaviors and favorable environment factors positively affected SHS (P < 0.001). Lifestyle behaviors had the largest effect on physical SHS (β = − 0.418), but the least on social SHS (β = − 0.274). Environment factors had the largest effect on mental SHS (β = 0.286), but the least on physical SHS (β = 0.225). Conclusions Lifestyle behaviors and environment factors were important influencing factors of SHS. Physical SHS was more associated with lifestyle. Lifestyle and environment were similarly associated with mental and social SHS.

Download Full-text