Employment status and self-rated health in north-western China

Objective: Despite a growing economy, unemployment remains a severe socio-economic problem in China. This study aimed to examine whether risk of self-rated poor health is related to employment status, and if any such relationship varies across sociodemographic groups. Study design: A cross-sectional analysis in a random sample survey conducted in three north-western Chinese cities in 2005. Methods: Subjects were 7796 adults aged 20-59 years who reported being either employed or unemployed but actively seeking work. Multinomial generalized estimating equation models were performed for ordered logistic regression to estimate the relative risk of self-reporting poor health on an ordinal five-point scale with regard to employment status. Results: Unemployment was associated with self-rated poor health (odds ratio 1.4, 95% confidence interval 1.25-1.55). This association was stronger for people who resided in Xining, were older, frequently consumed alcohol and possessed a strong social network. Likelihood of self-rated poor health increased with duration of unemployment up to 5 years, but then decreased. Conclusion: This study found that unemployment is detrimental to health, and that the relationship is modified by certain personality characteristics and social factors. An optimal strategy would incorporate such heterogeneity into Chinese programmes aimed at alleviating poor health among the unemployed. Published by Elsevier Ltd on behalf of The Royal Society for Public Health.