ArticleFrontiers in public health2026
Community-built environment and self-rated health in Western China: a latent serial mediation within SEM of sleep quality and family functioning.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: To clarify the underlying relationship between community-built environment and self-rated health in rapidly urbanizing China and examine the chained mediation effects of sleep quality and family functioning. Methods: Data were derived from a community-based cross-sectional survey conducted in Gaoping District, Sichuan Province. The Chinese versions of the Neighborhood Environment Walkability Scale-Abbreviated, the 36-Item Short Form Health Survey, the Insomnia Severity Index, and the Family Assessment Device were used to assess the community-built environment, self-rated health, sleep quality, and family functioning. Based on the Structural Equation Model, a structural equation model was constructed, and the weighted least squares mean- and variance-adjusted estimator was used to test the model. After the preliminary confirmatory factor analysis, model fit was evaluated using the comparative fit index, Tucker-Lewis's index, root mean square error of approximation, and standardized root mean square residual. Results: This study included 2,705 adults (mean age 51.8 ± 18.3 years; 60% female). After adjusting for socioeconomic characteristics, the community-built environment was not significantly associated with self-rated health (all Conclusion: In the mixed urban-rural context of western China, the community-built environment was not significantly associated with the self-rated health among community-dwelling adults. Notably, sleep quality was identified as the predominant factor affecting self-rated health outcomes.
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