Association between going out for work and self-rated health of rural residents: a longitudinal study in Ningxia, China

This study aims to examine the relationship between going out for work and self-rated health among rural residents in Ningxia while further investigating the mediating effects of health service utilization on this relationship. The findings provide policy recommendations for improving rural residents' health outcomes. Based on longitudinal data from the 2019 and 2022 "Ningxia Rural Household Health Survey" (including 13432 participants in 2019 and 12626 in 2022), ordered logit regression models and propensity score matching were utilized to analyse self-rated health. Robustness tests were conducted with different matching methods, with mediation effect analysis revealing potential pathways through health service utilization. On the basis of fully adjusted propensity score matching regression models, going out for work was significantly associated with improved self-rated health among rural residents (β = 0.292, P < 0.01). However, subgroup analyses revealed that this positive association was not statistically significant among divorced/widowed individuals (β = 0.052, P > 0.05), those with senior high school education or above (β = 0.107, P > 0.05), those without medical insurance (β = 0.528, P > 0.05), and those using flush toilets (β = 0.088, P > 0.05). Additionally, mediation analysis indicated that outpatient service utilization (β = 0.0043, P = 0.026) and inpatient service utilization (β = 0.0128, P < 0.01) mediated the relationship between going out for work and self-rated health. These findings suggest that going out for work positively influences rural residents' health, with health service utilization playing a significant role in this relationship. Encouraging individuals to work may not only promote employment but also contribute to improving rural residents' health outcomes.