Abstract
BACKGROUND: The prevalence of stress factors in urban settings has increased, with significant potential impact on health outcomes. OBJECTIVE: 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). METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.