Associations Between Short-Video Platform Use and Health Across Health Distribution and Usage Behaviors in China: Cross-Sectional Questionnaire Study.

Background: Short-video platforms, characterized by algorithmic curation and passive consumption, have emerged as dominant components of digital life. However, the associations between short-video platform use and health across different groups and usage behaviors remain understudied. Objective: This study investigates associations between short-video platform use and health, examining whether these relationships vary across health status, usage behaviors, and socioeconomic status. Methods: A cross-sectional study was conducted using multistage stratified sampling across eastern, central, and western China from July to September 2024. The inclusion criteria were age 18 years or older, ability to communicate effectively, and no cognitive disorders or mental disturbance. Of 7725 participants enrolled, 46.96% (n=3628) were male, and the average age was 65.49 (SD 8.39) years. The data were collected via face-to-face interviews using a structured questionnaire. Self-rated health and relative health deprivation (Kakwani index) were used to measure health. Quantile regression explored associations between whether using short-video platform and health varies across the health distribution, while linear regression examined associations of years, frequency, daily duration, and purpose diversity of short-video platform use with health. Moderating effect analysis explored the role of socioeconomic status in the relationship between the daily duration of use and health. Results: Coefficients were tested using 2-tailed t tests, and statistical significance was defined as a 2-sided P value less than .05. Quantile regression revealed heterogeneous associations. Compared to nonusers, short-video platform users had better self-rated health at the 70th to 90th quantiles and lower relative health deprivation at the 10th to 30th quantiles. However, the users at the 10th quantile of self-rated health had worse self-rated health (β=-2.224, 95% CI -3.835 to -0.613). Longer engagement (≥3 y) correlated with lower relative health deprivation (β=1.970, 95% CI 0.308-3.632), while daily use of 1-4 hours was associated with poorer self-rated health (β=-3.385, 95% CI -4.872 to -1.898; β=-3.038, 95% CI -5.054 to -1.022) and higher relative health deprivation (β=0.035, 95% CI 0.021-0.050; P<.001; β=0.034, 95% CI 0.014-0.054). Compared to no purposeful use, using with 2 purposes was associated with better self-rated health (β=6.082, 95% CI 0.250-11.914) and lower relative health deprivation (β=-0.063, 95% CI -0.120 to -0.005). The association was stronger for use with 3 or more purposes. Socioeconomic status moderated the relationship between daily duration of use and health. Conclusions: This study provides a more specific investigation of how these associations vary across health strata and usage patterns. The findings reveal patterns of benefit and risk across population subgroups, underscoring that how and why individuals engage with platforms matter more than mere access or frequency. These insights necessitate targeted digital well-being policies that protect vulnerable groups, particularly those in poor health or with lower socioeconomic status. Furthermore, policies should actively encourage intentional, functionally grounded use to reduce health inequities and advance equitable digital inclusion.