Geographical Disparities of Uncertainty Stress and Life Stress Among University Students: A Study Across All Provinces in Mainland China.

The study objective was to investigate geographical variation of uncertainty stress and life stress among university students in China. Respondents comprised 11,954 students from 50 universities and 31 provinces in China's mainland. Respondents completed the extended version of Global Health Professional Student Survey (GHPSS) on Tobacco Control in China, which added additional health, mental stress, and behavioural items on original version, and regional variables were retrieved from the National Bureau of Statistics database. Both unadjusted and adjusted methods were used in the logistic regression analysis. The prevalence of high uncertainty stress was 19.60% (95% CI: 15.90%, 23.30%), while the prevalence of life stress was 8.60% (95% CI: 7.20%, 10.70%). The prevalence rates varied significantly across the 31 provinces. The random parameters for uncertainty stress and life stress were statistically significant at the 0.01 level, with values of 0.2593 and 0.3971, respectively. The geographical distribution revealed two high uncertainty stress zones between the east coast and the middle area, as well as in the west area from south to north. High life stress, on the other hand, was concentrated in the central area. Multilevel logistic regression showed province level per capita disposal income of households partly contributed to uncertainty stress (OR = 0.52, 95% CI: 0.36, 0.94) and life stress (OR = 0.59, 95% CI: 0.52, 0.89). These findings underscore the importance of environmental contribution to mental stress among university students. Given that college students' mental stress is high, there is a need for environmental measurements to prevent and address multiple perceived stress in students.