title: 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.
authors.affiliation: School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, China. a2278197a@163.com.|Department of Traditional Chinese Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China. a2278197a@163.com.
authors.forename: Shengwei
authors.initials: S
authors.lastname: Wu
authors.affiliation: School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, China. 13268268154@163.com.|Department of Traditional Chinese Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China. 13268268154@163.com.
authors.forename: Zhengzheng
authors.initials: Z
authors.lastname: Xuan
authors.affiliation: School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, China. leephialf@126.com.|Department of Traditional Chinese Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China. leephialf@126.com.
authors.forename: Fei
authors.initials: F
authors.lastname: Li
authors.affiliation: School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, China. xw76888@126.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Xiao
authors.affiliation: School of Chinese Medicine, Hong Kong Baptist University, Hong Kong 999077, China. 13480405@life.hkbu.edu.hk.
authors.forename: Xiuqiong
authors.initials: X
authors.lastname: Fu
authors.affiliation: School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, China. 13427550499@163.com.|Department of Traditional Chinese Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China. 13427550499@163.com.
authors.forename: Pingping
authors.initials: P
authors.lastname: Jiang
authors.affiliation: School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, China. jieyu@smu.edu.cn.|Department of Traditional Chinese Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China. jieyu@smu.edu.cn.
authors.forename: Jieyu
authors.initials: J
authors.lastname: Chen
authors.affiliation: School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, China. xianglei9527@163.com.|Department of Traditional Chinese Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China. xianglei9527@163.com.
authors.forename: Lei
authors.initials: L
authors.lastname: Xiang
authors.affiliation: School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, China. siyecao2015@163.com.|Department of Traditional Chinese Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China. siyecao2015@163.com.
authors.forename: Yanyan
authors.initials: Y
authors.lastname: Liu
authors.affiliation: School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, China. nx117@163.com.|Department of Traditional Chinese Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China. nx117@163.com.
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Nie
authors.affiliation: School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, China. luoren2014@126.com.|Department of Traditional Chinese Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China. luoren2014@126.com.
authors.forename: Ren
authors.initials: R
authors.lastname: Luo
authors.affiliation: School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, China. sunxiaomin198001@163.com.
authors.forename: Xiaomin
authors.initials: X
authors.lastname: Sun
authors.affiliation: School of Chinese Medicine, Hong Kong Baptist University, Hong Kong 999077, China. hykwan@hkbu.edu.hk.
authors.forename: Hiuyee
authors.initials: H
authors.lastname: Kwan
authors.affiliation: School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, China. zhaoxs0609@163.com.|Department of Traditional Chinese Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China. zhaoxs0609@163.com.
authors.forename: Xiaoshan
authors.initials: X
authors.lastname: Zhao
mesh_terms: D000293:Adolescent; D000328:Adult; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006293:Health Promotion; D006304:Health Status; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D016272:Occupational Health; D016017:Odds Ratio; D011998:Recreation / Q000523:psychology*; D017132:Workplace / Q000523:psychology*; D055815:Young Adult
keywords: health-promoting lifestyles; suboptimal health status (SHS); work-recreation balance conditions