The Health Cost of Rural Banquet Culture: The Mediating Role of Labor Time and Health Decision-Making—Evidence from Jiangsu, China

Against the backdrop of health inequality among rural residents, focusing on the impact of cultural institutions during the transitional period on villagers’ health contributes to ensuring healthy lives for rural populations (SDG-3). Drawing on institutional theory, this study explores how rural banquet culture shapes residents’ health outcomes and the mechanisms through which this influence operates. Utilizing data from the 2021 China Land Economy Survey (CLES), we employ both mediation effect models and machine learning techniques. The findings indicate that a stronger presence of banquet culture within villages is significantly associated with poorer health outcomes among rural residents. Further analysis reveals that banquet culture is also correlated with increased adult and infant mortality rates and reduced life expectancy. Mechanism analysis shows that time crowding caused by social obligations and suboptimal health decision-making serve as important mediating pathways through which banquet culture influences health. Moreover, heterogeneity analysis suggests that higher levels of village autonomy and greater provision of public health goods can mitigate the negative health impacts of banquet culture. By uncovering the micro-level behavioral mechanisms through which cultural norms influence individual health, this research advances the understanding of informal institutions. It innovatively links ritualized social practices to measurable health outcomes, addresses a critical gap in public health research on rural populations, and provides policy-relevant insights for the development of targeted rural health interventions.