How Anxiety Shapes Students’ Self-Rated Health at Elite Universities: A Longitudinal Study

Self-rated health is a comprehensive indicator reflecting an individual's subjective assessment of their overall health status. The health condition of students in elite universities is directly related to the quality of talent reserves and the long-term development of the country. However, the multiple challenges they face make them prone to subhealth issues. To understand and effectively intervene in the health dilemmas of this group from a psychological perspective, this study constructed a cross-lagged model to examine the potential bidirectional relationship between anxiety and self-rated health. We utilized two-wave longitudinal data from a sample of 896 undergraduate students (mean age 21.37 years, 60.27% male, 92.08% Han nationality) from five elite universities in Beijing, China. Anxiety was measured using the Depression Anxiety Stress Scales, while self-rated health was assessed via a single-item score. The study revealed that during the two survey periods, the anxiety levels of elite university students decreased (7.682/7.462), whereas their self-rated health scores increased (81.781/83.255). Higher levels of anxiety were significantly associated with lower levels of self-rated health in both the concurrent and cross-lagged analyses (r = -0.299~-0.173, <i>p</i> < 0.01). Prior anxiety could predict later self-rated health (<i>β</i> = -0.081, <i>p</i> < 0.05), but the reverse path from self-rated health to anxiety was not confirmed. Our findings indicate that anxiety among elite university students has a unidirectional prospective effect on self-rated health. On the basis of these findings, universities should integrate mental health services into their routine work systems, and students should also increase their sense of personal responsibility for their own health, actively seeking effective pathways to improve their physical and mental well-being.