Pan, Yuwei; Bobak, Martin; Peasey, Anne; Pikhart, Hynek; Pikhartova, Jitka; (2025) Employment status and self-rated health among Chinese middle-aged and older workers: results from a nationwide longitudinal study. Journal of Epidemiology and Community Health 10.1136/jech-2024-223579. (In press).

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Abstract

BACKGROUND: The ageing workforce in China poses a challenge to the healthcare and social systems. This study investigated the association between employment categories and self-rated health (SRH) among Chinese middle-aged and older adults. METHODS: We analysed data from the baseline survey of the China Health and Retirement Longitudinal Study (14 445 participants aged 45 years and older). The association between employment status and SRH was analysed using multivariable logistic regression. Multiple imputation combined with inverse-probability weighting was performed to deal with missing covariate data and to account for complex survey design. RESULTS: The overall prevalence of poor SRH was 27.1%. After controlling for sociodemographic factors and health behaviours, adjusted ORs of poor SRH in non-agriculturally self-employed workers, agriculturally employed workers and agriculturally self-employed workers were 1.49 (95% CI 1.16 to 1.90), 1.58 (95% CI 1.13 to 2.22) and 2.17 (95% CI 1.76 to 2.68), compared with non-agricultural employees. The ORs of poor SRH were 2.61 (95% CI 2.04 to 3.35) in non-agricultural retirees and 4.37 (95% CI 3.41 to 5.59) in agricultural retirees. CONCLUSIONS: There are pronounced differences in SRH between employment categories and between rural and urban residents. Chinese non-agricultural employees had considerably better health than other working groups.

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