Social trust, interpersonal trust and self-rated health in China: a multi-level study.
Trust is important for health at both the individual and societal level. Previous research using Western concepts of trust has shown that a high level of trust in society can positively affect individuals' health; however, it has been found that the concepts and culture of trust in China are different from those in Western countries and research on the relationship between trust and health in China is scarce.



The analyses use data from the national scale China General Social Survey (CGSS) on adults aged above 18 in 2005 and 2010. Two concepts of trust ("out-group" and "in-group" trust) are used to examine the relationship between trust and self-rated health in China. Multilevel logistical models are applied, examining the trust at the individual and societal level on individuals' self-rated health.



In terms of interpersonal trust, both "out-group" and "in-group" trust are positively associated with good health in 2005 and 2010. At the societal level, the relationships between the two concepts of trust and health are different. In 2005, higher "out-group" social trust (derived from trust in strangers) is positively associated with better health; however, higher "in-group" social trust (derived from trust in most people) is negatively associated with good health in 2010. The cross-level interactions show that lower educated individuals (no education or only primary level), rural residents and those on lower incomes are the most affected groups in societies with higher "out-group" social trust; whereas people with lower levels of educational attainment, a lower income, and those who think that most people can be trusted are the most affected groups in societies with higher "in-group" social trust.



High levels of interpersonal trust are of benefit to health. Higher "out-group" social trust is positively associated with better health; while higher "in-group" social trust is negatively associated with good health. Individuals with different levels of educational attainment are affected by trust differently.
Centre for Research on Ageing, Social Sciences, Faculty of Social, Human and Mathematical Sciences, University of Southampton, Southampton, UK.
Zhixin
Z
Feng
Centre for Research on Ageing and ESRC Centre for Population Change, Social Sciences, Faculty of Social, Human and Mathematical Sciences, University of Southampton, Southampton, UK.
Athina
A
Vlachantoni
School of Public Affairs, Zhejiang University, 866 Yuhangtang Road, Hangzhou, Zhejiang Province, 310058, China. xtliu@zju.edu.cn.
Xiaoting
0000-0002-8386-9515
X
Liu
School of Geographical Sciences, University of Bristol, Bristol, UK.
Kelvyn
K
Jones
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D055361:Multilevel Analysis; D011203:Poverty / Q000706:statistics & numerical data*; D012111:Residence Characteristics; D012424:Rural Population / Q000706:statistics & numerical data; D058992:Social Participation; D012959:Socioeconomic Factors; D035502:Trust; D014505:Urban Population / Q000706:statistics & numerical data
China; Multi-level modelling; Self-rated health; “in-group” trust; “out-group” trust