Healthcare workers in China are exposed to extremely high job stress and inequitable work conditions, and the Healthy China 2030 blueprint has made them an important focus of policymakers. To examine the importance of distributive justice in Chinese medical reform, we analyzed data from 1542 healthcare workers employed in 64 primary, secondary and tertiary hospitals in 28 Chinese cities in Western, Central and Eastern China in 2018. Supervisor support, coworker support, distributive justice, and presenteeism were assessed with the supervisor support scale, coworker support scale, distributive justice scale and perceived ability to work scale, respectively. Structural equation modeling was used to examine relationships among variables. The mediating effect of distributive justice on associations between supervisor support, coworker support, and presenteeism was examined with the Sobel test. The results revealed that significant indirect effects between supervisor support and presenteeism and between coworker support and presenteeism were significantly mediated by distributive justice. Better supervisor and coworker support might improve distributive justice among healthcare workers in Chinese hospitals, thereby increasing their performance.

Despite a growing literature on the topic, the association between neighborhood greenness and body weight is inconsistent. The objective of this research is to examine the association between neighborhood greenness and residents' obesity levels in a high population density area. We accounted for three greenness features: green access, green exposure, and view-based green index. We used the novel technique of deep convolutional neural network architecture to extract eye-level information from Baidu Street View images to capture the urban vertical greenness level. The research involved a survey with 9,524 respondents from 40 communities in Shanghai. Generally, we found all aspects of horizontal greenery, vertical greenery, and proximity of green levels to be impactful on body weight; however, only the view-based green index consistently had an adverse effect on weight and obesity.

Promoting a healthy diet through education is part of the Healthy China 2030 action plan. However, studies examining how dietary knowledge affects public health in China are sparse. This study employs multiple waves of the China Health and Nutrition Survey (CHNS) data to examine the impacts of dietary knowledge on Chinese adults’ health, with a particular emphasis on how the impacts of dietary knowledge vary across different demographic groups. Moreover, we contribute to the literature by incorporating the spouse’s dietary knowledge into the analysis framework to inspect the relationship between a spouse’s dietary knowledge and an individual’s health. Our results indicate that dietary knowledge significantly improves an individual’s health status. However, there is no evidence that an individual’s health is influenced by his/her spouse’s dietary knowledge. Moreover, we find that individuals with a lower level of education and rural residents benefit more from increasing dietary knowledge. Policy implications of this study are also discussed.

Background Job stress is a strong indicator of presenteeism, but few studies have examined its diverse effects and mediators on presenteeism. This study explored the relationships between job stress, public service motivation (PSM) and presenteeism and how job stress and PSM influence presenteeism in a large national sample of Chinese healthcare workers. Methods A cross-sectional survey including 1392 healthcare workers from 11 Class A tertiary hospitals in eastern, central and western China was used in the analysis. Descriptive statistical analysis, correlation analysis and structural equation modeling were used to test the research hypothesis. Results Hindrance stress was inversely associated with PSM (β = − 0.27; P < 0.001) but significantly positively associated with presenteeism (β = 0.35; P < 0.001). PSM was directly inversely associated with presenteeism (β = − 0.35; P < 0.001). PSM partially mediated the relation of hindrance stress with presenteeism. Conclusions The findings suggest that efforts to prevent presenteeism among healthcare workers in China should emphasize PSM improvement and reduction of hindrance stress.

BackgroundHealthcare reform in China has attracted worldwide interest and reached a new juncture. In an attempt to improve healthcare quality and patient satisfaction, the government of Beijing introduced comprehensive reform of urban public hospitals in 2016 and implemented new policies on personnel, compensation, management, and diagnosis and treatment. As the agents of healthcare service, and a target of reform measures, healthcare workers were greatly affected by these reforms but have not been carefully studied.MethodsThis study used mean value analysis, variance analysis, and qualitative content analysis to investigate the status of healthcare workers after comprehensive reform of urban public hospitals in Beijing.ResultsWe found a gradual but constant increase in the number of healthcare workers in poor health in Beijing public hospitals. After the reforms, this population reported high challenge stress, public service motivation, job satisfaction, job performance and quality of healthcare, moderate presenteeism, and low hindrance stress and turnover intention. The status of healthcare workers differed by subgroup and changed during the reform process.ConclusionsOur study provides data useful for policy recommendations regarding the implementation and extension of future reforms and offers important lessons for developing and developed countries that are reforming public hospitals to improve efficiency and reduce costs.