Geographical Disparities of uncertainty stress and life stress among university students in China

Abstract Background Ecological models have emphasized that mental stress both is an individual phenomenon and an environmental outcome. However, many mental stress studies focused primarily on individual variables. Few studies have examined the geographical disparities in mental stress, with no comparable studies implemented on this issue with regard to different type of mental stress. This study investigates geographical variations in overall stress, uncertainty stress and life stress among university students in China. Methods Respondents comprised 11,954 students from 50 universities and 31 provinces in Mainland China. Respondents completed the extended version of the Global Health Professional Student Survey (GHPSS) on Tobacco Control in China. The survey included additional health, mental stress, and behavioral items along with regional variables which were retrieved from the National Bureau of Statistics database. Both unadjusted and adjusted methods were used in the logistic regression analysis. Results Uncertainty stress and life stress prevalence were 19.6% (95% CI: 15.9%, 23.3%) and 8.6% (95% CI: 7.2%, 10.7%) respectively, while overall stress prevalence was 37.2%, 95% CI: 24.7%, 49.7%). All stresses varied widely across the 31 provinces. Random parameters of 0.3971 for life stress, 0.2593 for uncertainty stress, and 0.1449 for overall stress were statistically significantly at the 0.01 level, in terms of their geographical distribution, high life stress was concentrated in central provinces, high uncertainty stress mainly in both central and western provinces, while provinces displaying higher overall stress tended to display a north-south distribution. Multilevel logistic regression showed province level per capital disposable income of households partly contributed to uncertainty stress (OR: 0.52) and life stress (OR: 0.59). Conclusions This study maps the geographical distribution of uncertainty stress, life stress, and overall stress in China. These findings underscore the importance of environmental factors affecting stress levels among university students.