Work-Recreation Balance, Health-Promoting Lifestyles and Suboptimal Health Status in Southern China: A Cross-Sectional Study

Abstract

Suboptimal health status (SHS)—an intermediate state between health and illness—refers to functional somatic symptoms that are medically undiagnosed. Although SHS has become a great challenge for global public health, very little about its etiology and mechanisms are known. Work-recreation balance is a part of work−life balance, and is related to stress which greatly influences health status. We therefore carried out a cross-sectional investigation between 2012 and 2013 within a clustered sample of 24,475 individuals aged 15−60 years from a population in southern China. In so doing, we hoped to illuminate the associations between work-recreation balance conditions, healthy lifestyles, and SHS. Work-recreation balance conditions were categorically defined by frequency (“rarely, sometimes, or always”). Health-Promoting Lifestyle Profile (HPLP-II) was used to evaluate the level of healthy lifestyles, and the medical examination report and Sub-Health Measurement Scale V1.0 (SHMS V1.0) were both used to evaluate health status. The ratio of SHS (46.3%) is higher than health status (18.4%) or disease status (35.3%). Overall, 4.9% of respondents reported the lowest level of work-recreation balance, and they scored lower on both the HPLP-II and SHMS V1.0 compared with those who frequently maintained a work-recreation balance. Significant association was found between work-recreation balance behaviors and healthy lifestyles (p < 0.001) after demographic adjustment. In comparison with those reporting a frequent work-recreation balance, individuals whose work-recreation balance was categorically “rare” were 1.69 times as likely to develop SHS (odds ratio (OR): 1.69, 95% confidence interval (CI): 1.49–1.92), and those with infrequent work-recreation balance (“sometimes”) were 1.71 times more likely to develop SHS (OR: 1.71, 95% CI: 1.62–1.81). These findings suggest that work-recreation balance conditions are significantly associated with, and seem to be accurate behavioral indicia of a healthy lifestyle. Poor work-recreation balance is associated with increased risk for SHS; thus, a healthier lifestyle that maintains a work-recreation balance should be promoted in order to reduce the development of SHS or disease in southern China.

Association between Ideal Cardiovascular Health Metrics and Suboptimal Health Status in Chinese Population

“…Consistent with our previous study 7 and other studies which reported that unhealthy lifestyle determined by the Health-promoting Lifestyle Profile (HPLP-II), work-recreation balance and breakfast eating habits were also reported to be associated with SHS in multiple studies 8 – 10 , 16 , healthy diet intake is associated with a lower risk of suffering SHS, and smoking or physical inactivity are associated with risk of SHS. Taken together, health behaviors play important roles in contributing to the association between SHS and risk of cardiovascular events.…”

“…The present finding that intermediate control of blood pressure negatively correlates with SHS score is inconsistent with our previous study that blood pressure is elevated in the participants with higher SHS score. A cross-sectional study conducted in Samara of Russia showed that blood pressures are not statistically correlated with SHS score (beta = 0.069, p = 0.199 and beta = −0.040, p = 0.416 for SBP and DBP, respectively) 10 . These inconsistencies remain unexplained, but there are 3 possible explanations.…”

“…In a cross-sectional study of Chinese students, SHS was showed to be correlated with lifestyle factors, including physical activity, health responsibility, spiritual growth, interpersonal relations and stress management 8 . Poor work-recreation balance and irregular breakfast eating habits were reported to be associated with increased risk for SHS in a cross-sectional study conducted in southern China 9 , 10 . In a community-based cross-sectional study conducted in Russia, SHS is showed to be associated with endothelial dysfunction, suggesting integration of suboptimal health status and endothelial dysfunction can be applied to routine screening for risks of cardiovascular diseases 11 .…”

Prevalence of Suboptimal Health Status and the Relationships between Suboptimal Health Status and Lifestyle Factors among Chinese Adults Using a Multi-Level Generalized Estimating Equation Model

“…Wu et al reported that poor work-recreation balance was associated with increased risk for suboptimal health status [38]. Chang et al found that suboptimal health status among middle school teachers was closely related to occupational stress [39].…”

Prevalence and Associated Lifestyle Factors of Suboptimal Health Status among Chinese Children Using a Multi-Level Model

“…Chen et al considered that SHS was highly attributable to unhealthy lifestyles, and the mitigation of modifiable lifestyle risk factors may lead to SHS regression for college students [28]. Several studies also found that many lifestyle factors were closely associated with SHS among adults [5,29,30,35]. In our previous study, unhealthy lifestyles were found closely associated with SHS among adults aged above 18 years old, including smoking, drinking alcohol, short sleep duration, poor sleep quality, lack of regular exercise, stress, negative life events, unhealthy diet choices, and irregular meal times [7].…”