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.

Tao Xu,Shaomei Han,Guangjin Zhu

doi:10.3390/ijerph17030763

Abstract

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.

Highlights

The World Health Organization defines health in its broader sense as a state of complete physical, mental, and social well-being, rather than merely as the absence of disease or infirmity [1]
The health status of the population could be effectively improved by improving lifestyle behaviors
This was the first study to explore the prevalence of suboptimal health status and the relationships of suboptimal health status and lifestyle factors using multi-level generalized estimating equation (GEE) models controlled for the cluster effect of the same living area and similar living circumstances to guarantee the accuracy and generalizability of the study results

Summary

Introduction

The World Health Organization defines health in its broader sense as a state of complete physical, mental, and social well-being, rather than merely as the absence of disease or infirmity [1]. With advancing understanding of health, this definition has expanded to consider suboptimal health status. There is currently no common definition for suboptimal health status, people usually consider suboptimal health as a borderline state between health and disease, characterized by declines in vitality, physiological function, and the capacity for adaptation, and including medically undiagnosed or functional somatic syndromes [2,3]. Suboptimal health has attracted increasing attention from medical professionals as an important public health issue [4,5]. It is important to properly assess suboptimal health and explore the factors associated with suboptimal health to prevent diseases and improve human health

Objectives

Methods

Results

Discussion

Conclusion