Work, marriage and community context effects on health among a cohort of Chinese women.

다국어 초록 (Multilingual Abstract)

Background. The economic system transformation in China has had a profound effect on individual health and well-being.
Objective. To assess the effects of work involvement, marital status and transitions, and community context on women's health.
Methods. Data are derived from the China Health and Nutrition Survey. 2530 women aged 20--59 in the 1991 survey and follow-up interview in 1993 and/or in 1997 are selected. Two-level logistic and poisson random intercept models are estimated to assess the effects of work involvement, marital status and transitions, and community context on women's health measured as self-rated health, reported illness in the last four weeks, hypertension and being overweight.
Results. Wage work is beneficial for Chinese women's perceived health, compared to non-wage work categories such as field work, farm work and sideline activities (statistically significant logged odds are -0.37, -0.31 and -0.34, respectively, in the saturated model for overall women and -0.49, -0.39 and -0.67, respectively, in the saturated model for rural women). Both women never married and divorced, widowed or separated have a higher risk for hypertension (OR=1.70, 95% CI: 0.66-4.36 and OR=2.01, 95% CI: 1.01-3.99, respectively) relative to married women. Women with marital transitions are more likely to be at risk for hypertension (OR=2.03 for those exiting marriage, 95% CI: 1.12-3.70 and OR=2.54 for those entering marriage, 95% CI: 0.98-6.54) relative to women staying married. A similar effect pattern is found among women without hypertension in 1991 from a poisson model of incidence rate. Community variables are found to have independent effects on one or more specific subjective and objective health measures beyond a set of individual variables. There is no consistent pattern of community effects on either subjective or objective health measures.
Conclusions. A detailed work typology more appropriately approximates the effects of work involvement on women's health in China, especially in rural China. Married women are less likely to be at risk for hypertension, while women experiencing marital transitions are more likely to suffer short-term adverse health effects. The community context where women live is also important to understand in explaining variation in health status.