Social trust, interpersonal trust and self rated health in China: a multi level study
BackgroundTrust 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.MethodThe 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.ResultsIn 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.ConclusionHigh 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.
International Journal for Equity in Health