Socio-economic development and emotion-health connection revisited: a multilevel modeling analysis using data from 162 counties in China

Background: Substantial research has shown that emotions play a critical role in physical health. However, most of these studies were conducted in industrialized countries, and it is still an open question whether the emotionhealth connection is a "first-world problem". Methods: In the current study, we examined socio-economic development's influence on emotion-health connection by performing multilevel-modeling analysis in a dataset of 33,600 individuals from 162 counties in China. Results: Results showed that both positive emotions and negative emotions predicted level of physical health and regional Gross Domestic Product Per Capita (GDPPC) had some impact on the association between emotion and health through accessibility of medical resources and educational status. But these impacts were suppressed, and the total effects of GDPPC on emotion-health connections were not significant. Conclusions: These results support the universality of emotion- health connection across levels of GDPPC and provide new insight into how socio-economic development might affect these connections.