Patterns and correlates of stress among rural Chinese males: a four-region study.

OBJECTIVES Prior research has revealed a high prevalence of stress among general urban populations in China. However, little is known about stress in rural Chinese counterparts. This research estimates the prevalence of severe stress among rural Chinese males and identifies sociodemographic and psychological correlates. STUDY DESIGN The study design was a cross-sectional survey with multistage sampling. METHODS Subjects were male residents aged > or =15 years from four geographic regions of China (N=4414), namely Jinbei, Jinnan, Guidongbei and Subei. Information was collected on perceived stress and potential sociodemographic and behavioural correlates as well as on perceived health status. Data were assessed by means of chi(2) tests and unconditional logistic regression analysis. RESULTS The mean score for the rural male resident sample on the Chinese Perceived Stress Scale (CPSS) was 24.8 (standard deviation=7.7), and 44% of subjects reported severe stress. With Subei residents as the referent, respondents from Guidongbei region [adjusted odds ratio (OR)=0.66; 95% confidence interval (CI)=0.52-0.84] had a lower likelihood of reporting severe stress and those from Jinbei region (OR=3.54; 95% CI=2.85-4.39) and Jinnan region (OR=2.73; 95% CI=2.21-2.39) had higher likelihoods. Respondents aged 35-44 years (OR=0.69; 95% CI=0.55-0.85) and > or =45 years (OR=0.67; 95% CI=0.54-0.83) had a lower likelihood of reporting severe stress than those aged <25 years, and respondents in non-farming jobs (OR=1.33; 95% CI=1.09-1.62) had an excess likelihood relative to those in farming. An excess likelihood of reporting severe stress was manifest among the divorced and widowed relative to the unmarried, and a lower likelihood was observed among respondents with a higher education relative to the least educated. Hedonism seeking was positively associated with severe stress among rural Chinese males (OR=2.43; 95% CI=2.09-2.84) and social participation was negatively associated (OR=0.62, 95% CI=0.54-0.73). CONCLUSIONS This study found a high stress level among rural Chinese males. To ameliorate this problem, we recommend policy and prevention initiatives at national and local levels.