BMC public health · 2026
Gender-patterned associations of exposure, coping, and health outcomes of perceived unfairness stress in urban China.
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Jiang Shuhan, Sheng Mingyuan, Ye Jiayao, Liao Zhaoqing, Lu Qi, Zhang Weifang
Аннотация
BACKGROUND: Perceived unfairness stress (PUS) is recognized as a chronic social stressor affecting wellbeing globally. In China, rapid socioeconomic change and persistent gender norms make the pathways from unfairness to health outcomes especially complex, yet underexplored.
OBJECTIVES: This research examines gender-patterned associations among perceived unfairness stress, coping strategies in response to unfairness, and unfairness-related health outcomes among urban Chinese adults.
METHODS: A sample of 2,843 adults aged 18-85 from four provincial capitals was collected using multistage stratified sampling in 2021. PUS was measured across seven life domains. Coping responses to unfairness-related stress were assessed using a self-reported measure of primary coping strategy. Unfairness-related health outcomes were operationalized as experiencing at least one of three stress-related symptoms attributed to unfair treatment. Logistic regression models were estimated separately for male and female participants, controlling for socio-demographic covariates.
RESULTS: Overall, 33.6% of respondents reported severe perceived unfairness stress and 38.5% reported unfairness-related health outcomes. Education and promotion were the most frequently reported domains of unfairness for both genders; healthcare-related unfairness ranked third among women, whereas men more frequently reported other domains. Stratified analyses revealed gender-patterned associations. After adjustment for life stress and other covariates, severe PUS remained associated with higher odds of unfairness-related health outcomes among men, whereas this association was not observed in women. In contrast, life stress was the only stress indicator consistently associated with unfairness-related health outcomes in the female models. Regarding coping strategies, active coping was associated with a lower likelihood of unfairness-related health outcomes compared with avoidant coping among men, while no comparable pattern was observed among women.
CONCLUSIONS: Perceived unfairness stress and unfairness-related health outcomes were common among urban adults in China. The findings suggest that coping responses and gendered social contexts may shape how individuals experience and respond to unfairness-related stress. Interventions aimed at reducing perceived unfairness in domains such as education and promotion, together with gender-sensitive stress-management strategies, may help mitigate stress-related health symptoms.
OBJECTIVES: This research examines gender-patterned associations among perceived unfairness stress, coping strategies in response to unfairness, and unfairness-related health outcomes among urban Chinese adults.
METHODS: A sample of 2,843 adults aged 18-85 from four provincial capitals was collected using multistage stratified sampling in 2021. PUS was measured across seven life domains. Coping responses to unfairness-related stress were assessed using a self-reported measure of primary coping strategy. Unfairness-related health outcomes were operationalized as experiencing at least one of three stress-related symptoms attributed to unfair treatment. Logistic regression models were estimated separately for male and female participants, controlling for socio-demographic covariates.
RESULTS: Overall, 33.6% of respondents reported severe perceived unfairness stress and 38.5% reported unfairness-related health outcomes. Education and promotion were the most frequently reported domains of unfairness for both genders; healthcare-related unfairness ranked third among women, whereas men more frequently reported other domains. Stratified analyses revealed gender-patterned associations. After adjustment for life stress and other covariates, severe PUS remained associated with higher odds of unfairness-related health outcomes among men, whereas this association was not observed in women. In contrast, life stress was the only stress indicator consistently associated with unfairness-related health outcomes in the female models. Regarding coping strategies, active coping was associated with a lower likelihood of unfairness-related health outcomes compared with avoidant coping among men, while no comparable pattern was observed among women.
CONCLUSIONS: Perceived unfairness stress and unfairness-related health outcomes were common among urban adults in China. The findings suggest that coping responses and gendered social contexts may shape how individuals experience and respond to unfairness-related stress. Interventions aimed at reducing perceived unfairness in domains such as education and promotion, together with gender-sensitive stress-management strategies, may help mitigate stress-related health symptoms.