Modifiable determinants of physical, mental and social well-being in Chinese adolescents: a national environment-wide association study.

BACKGROUND: While the World Health Organization defines health through physical, mental, and social well-being, public health strategies often address single domains. This study identifies modifiable factors influencing all three dimensions in adolescents. METHODS: A national environment-wide association study (EnWAS) analyzed longitudinal data from 2370 Chinese children (aged 2-5 at baseline, final N = 1496) in the China Family Panel Studies (2010-2018). Seventy-one environmental factors across five domains (community characteristics, household characteristics, child health and behaviors, parenting behaviors and cognitive enrichment, and parental well-being) were assessed. A two-stage analysis combined false discovery rate-adjusted regression and LASSO variable selection. RESULTS: Self-esteem was the sole factor prospectively linked to all three dimensions: a 1-SD increase predicted better physical (0.20 point, 95 % CI = 0.14-0.26), mental (0.62 point, 95 % CI = 0.47-0.77), and social well-being (0.55 point, 95 % CI = 0.40-0.71). Paternal interpersonal popularity correlated with improved physical and mental well-being, while limiting a child's TV time enhanced mental and social outcomes. Eleven additional factors showed domain-specific associations, including higher paternal age and quarrels with parents in the last week. CONCLUSION: The study underscores the value of data-driven approaches in identifying cross-domain determinants while addressing limitations of single-dimensional well-being research. By bridging gaps between theoretical frameworks and empirical validation, this work informs population-level strategies to concurrently enhance physical, mental, and social health during critical developmental windows.