Neighborhood disadvantage and self-rated health in China: latent class analysis of community lifestyles

Background Existing research on residents' health has focused predominantly on individual socioeconomic status (SES), which is often explained through the "social causality" theory of health inequality, with less attention given to neighborhood disadvantage in China. Furthermore, even within the same community context, the degree of association between different residents and the community varies. Therefore, this study aims to systematically examine the impact of neighborhood concentrated disadvantage and the moderating role of exposure to advance intervention strategies for addressing health inequalities at the community level and establish a scientific foundation for promoting health equity. Methods Based on data from the 2018 China Labor Data Study, this study first employed latent class analysis (LCA) to identify distinct lifestyle types related to community exposure among urban residents in China. Second, multilevel analysis was used to examine the association between community context and resident health. Results The LCA revealed three distinct lifestyle types among urban residents: passive, active, and mixed. Multilevel analysis demonstrated that residents in communities with higher levels of concentrated disadvantage reported significantly poorer self-rated health. The exposure levels of different resident groups within a community moderated the strength of the association between the community context (concentrated disadvantage) and resident health. Conclusion Community governance should consider not only the influence of the community social structure but also the varying associations that different groups have with the community. This highlights the need for targeted interventions that account for both structural and individual-level factors in health inequality.