Socio-economic status, self-rated health and mental health: the mediation effect of social participation on early-late midlife and older adults

Netta Achdut,Orly Sarid

doi:10.1186/s13584-019-0359-8

Netta Achdut, Orly Sarid

Open Access

https://doi.org/10.1186/s13584-019-0359-8

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Abstract

BackgroundSocioeconomic status (SES) is a major determinant of diverse health outcomes, among these are self-rated-health and mental health. Yet the mechanisms underlying the SES—health relation are not fully explored. Socioeconomic inequalities in health and mental health may form along several pathways. One is social participation which is linked to better self-rated-health and mental health. We examined (1) whether various social participation practices, including the usage of information and communication technology, relate to a unidimensional or multidimensional phenomenon (2) the relationship among SES, social participation, self-rated-health and mental health; (3) whether social participation and mental health mediates the association between SES and self-rated-health; (4) whether social participation and self-rated-health mediates the links between SES and mental health.MethodCross-sectional data for individuals aged 35 and older were taken from the Israeli Social Survey for 2016 (N = 4848). Social participation practices included connection with family and friends, self-perceived-support, self-perceived trust, volunteering, civic and political involvement, and information and communication technology usage. An exploratory factor analysis was conducted for all social participation practices. We then constructed structural Equation Modeling (SEM) to explore paths of relations among SES, social participation, self-rated-health and mental health.ResultsWe found disparities in self-rated health and mental health across SES. Social participation practice, ‘frequency of meeting with friends’, mediated the links between SES-self-rated health and SES-mental health. Formal social participation practices along with internet usage mediated the SES- self-rated health link. Informal social participation practices and self-perceived trust mediated the SES-mental health link. Mental health mediated the SES- self-rated health link and self-rated health mediated the SES-mental health link.ConclusionThe links between SES and the two health constructs were enhanced by common and distinct social participation practices. Enhancement of social participation practices among low SES individuals is recommended. Social participation should be a prominent aspect of preventive medicine practice and health promotion interventions. Policy makers are called to support such programs as an important way to promote public health.

Highlights

Socioeconomic inequalities in health are an important topic in social sciences and public health
social participation (SP) was associated with better self-rated health (SRH) and mental health (MH): factor 1 correlated with SRH, whereas factor 2 (‘satisfaction with family relations’1 and ‘having people to count on’) correlated with MH
The enhancement of SP practices should be considered as a way to promote health—in older adults, and in early-late midlife adults

Summary

Introduction

Socioeconomic inequalities in health are an important topic in social sciences and public health. Since the Black Report of 1980, which established the structural explanation for health inequality over competing explanations [1], considerable effort has been invested to understand what causes these disparities, so as to be better able to identify measures to reduce them [2]. According to the structural explanation, health inequalities are the unjust differences in health between groups of people occupying different positions in society. Differences in the socioeconomic circumstances of social groups along the lifecourse cause differences in health outcomes. Structural theorists view competing explanations for health disparities as mechanisms linking structural determinants and health outcomes. The Black Report claimed that the causal explanation of health disparities is rooted in socioeconomic inequalities [2, 3]. One is social participation which is linked to better self-rated-health and mental health. We examined (1) whether various social participation practices, including the usage of information and communication technology, relate to a unidimensional or multidimensional phenomenon (2) the relationship among SES, social participation, self-rated-health and mental health; (3) whether social participation and mental health mediates the association between SES and self-rated-health; (4) whether social participation and self-rated-health mediates the links between SES and mental health

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Conclusion