Health of the Chinese university students in an era of globalisation

**Background and aim** The fast globalisation process has exponentially increased the flows of people, goods, capital as well as ideas across borders in the last decades. This process has had a fundamental impact on the development of China’s economy, as well as higher education in China. Between 1997 and 2006 the number of enrolment at higher educational institutes in China has increased fourfold with increasing international students studying on Chinese campuses. At the same time, an accelerating number of Chinese students enrol at Western universities. The aim of this work was to obtain a comprehensive insight into the subjective health of the Chinese university students in front of the background of increasing international mobility. The research focused on health indicators and their associated factors of Chinese university students in comparison with international students studying at Chinese university and university students in Germany. **Methods** Data used were from two student health surveys, one was conducted in 2006–2007 among (N = 3,306) students at 16 German universities, another in 2010–2011 at two Chinese universities (N = 1,853, including 1,543 Chinese and 300 international students). In both surveys, the applied self-administered questionnaire contained questions concerning socio-demographic information, lifestyle-related attributes, a perceived stress scale, a health complaint (HC) list, as well as two variables measuring alcohol consumption frequency and problem drinking prevalence. In the Chinese survey, the 18-item Study-related Life Satisfaction Scale, the Leipzig Short Scale of Sense of Coherence (SOC-L9) were also included. The research objectives were: 1) assessing the levels of perceived stress and study-related life satisfaction among Chinese students from a perspective in comparing with international students studying at Chinese universities with an emphasis of the Only-Child (OC) role; 2) assessing the rate of HCs, alcohol consumption prevalence and the associated factors with such prevalence among Chinese students in a comparative approach with German students; 3) identifying the associated factors of Sense of Coherence (SOC) in Chinese students. **Results** Chinese and international students did not differ with respect to the levels of perceived stress or study-related life satisfaction. Chinese Non-only-children (NOCs) were more dissatisfied than Only-children (OCs) (OR = 1.37, 1.09-1.73) in study-related life satisfaction. The Chinese NOCs were also more stressed than OCs (OR = 1.39, 1.11-1.74) with a stronger association among men (OR = 1.48, 1.08-2.02) than women (OR = 1.26, 0.89-1.77). Among the international students no association between OC status, perceived stress and study-related life satisfaction was found. In the Sino-German comparison, more German students reported multiple HCs (47.2 vs. 35.8%) and “At least once a week” alcohol consumption (59.8 vs. 9.0%) than Chinese students. Age showed a positive association with “At least once a week” drinking among the Chinese (OR = 1.33, 1.21-1.46), but a negative association among the Germans (OR = 0.97, 0.94-0.99). Perceived stress is positively related to problem drinking (OR = 1.08, 1.04-1.13) but not associated with occasionally drinking. Whereas a positive association between HCs and perceived stress, and between physical activity frequency and alcohol use was reported in both Chinese and German students, the gender difference in terms of females reporting more frequent HCs and less alcohol consumption especially less problem drinking (OR = 0.32, 0.26-0.40) was only found among the German students. For both student groups having a father with a high educational degree was related with “At least once a week” alcohol consumption (OR = 1.32, 1.01-1.27 for the Germans; OR = 4.25, 2.67-6.78 for the Chinese). A strong SOC was found to be positively associated with social support (OR = 2.56, 1.87-3.50), paying more attention to nutrition (OR = 1.67, 1.04-2.69), being better in academic performance compared with peers (OR = 1.64, 1.15-2.34), being not isolated at the university (OR = 1.60, 1.04-2.47), and being satisfied with the political situation (OR = 2.05, 1.57-2.67). Whereas perceived stress shows a negative impact (OR = 0.81, 0.79-0.83) on developing a strong SOC. **Conclusions** The results of this research highlight the relatively high prevalence of HCs among university students and the negative impact of stress on students’ health. The results suggest providing stress management, promoting integration and participation at Chinese universities to promote students’ subjective health. The differences in alcohol consumption and its related factors between Chinese and German students provide empirical evidence for the importance of culture sensitive intervention. At the same time, the research findings give hints to the impact of social and political dimensions on student health.