Economics and health status in China: A repeated cross-sectional study of China Family Panel Studies (CFPS) 2016 and 2020

Abstract This study examines the association between economic status and health outcomes across China, utilizing data from the China Family Panel Studies (CFPS) for 2016 and 2020. The "Healthy China 2030" initiative underscores the importance of addressing key determinants of health, prompting a closer examination of the interplay between economic factors and health indicators. This study employs multivariate multilevel logistic regression models to explore how individual, household, and provincial economic variables influence Body Mass Index (BMI) and self-rated health (SRH) status. Results reveal nuanced associations between economic status and health outcomes. At the province level, increased mean income negatively correlates with optimal BMI levels, while higher provincial expenditure is positively associated with optimal BMI. At the individual or household level, higher expenditure on tourism associates with better self-rated health, suggesting a positive link between leisure spending and perceived health. Per capita living space and the total value of durable consumer goods also associate with one’s BMI and SRH, reflecting the broader socio-economic context of individuals' health. Geographical disparities in health outcomes persist, with southern provinces generally exhibiting healthier BMI profiles compared to their northern counterparts. However, Shanxi (a province in the North) stands out with the highest odds of good SRH, indicating regional variations in subjective health assessments. Spatial analysis reveals a negative correlation trend between BMI and SRH across provinces, highlighting the complex interplay between objective health measurements and subjective health perceptions. This study emphasizes the importance of targeted interventions to address health disparities and promote healthy lifestyles across different regions in China. Enhancing healthcare accessibility in economically disadvantaged areas, investing in tourism and recreational infrastructure, and tailoring public health initiatives to local socio-economic contexts are essential steps towards fostering a more equitable and healthy society.