Impact of Perceived Unfairness, Uncertainty, and Life Stress on Urban Residents’ Health in China: Cross-Sectional Study

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.