The Psychological Mediators of Social Inequalities in Health: Self-efficacy in Europe and Russia

Abstract

This study is devoted to psychologically mediating the social structuring of health. According to theoretical views, which have not yet received a convincing justification, the decline in the social status of an individual is accompanied by the loss of the psychological resources necessary to overcome the difficulties of life and the stresses caused by them, which leads to deteriorating health in the lower social strata. The verification of this assumption was carried out using data from the European Social Survey — representative surveys of the population of 27 countries conducted in 2012–2013. Studying indirect psychological effects has demonstrated that in many of these countries such a psychological characteristic as self-efficacy is indeed a mediator of the social structuring of health, especially prominent in many post-communist societies, but not in the most developed western countries where mediating effects turned out to be weak or completely absent. A two-level analysis of psychological mediation, depending on the factors of the economic well-being of countries, the development of a social state and cultural identity, does not support the assumption of the importance of an individualistic culture for the manifestation of mediation, and convincingly demonstrates that indirect effects are related to the social and economic context. In countries with a strong economy and social state, the distribution of psychological resources is barely related to the social structure — the relative well-being of the lower social strata, due to the developed system of state social guarantees, allows for many of them to maintain self-respect and optimism. Psychological resources, the distribution of which does not reflect social stratification, lose the role of a mediator. In the less developed part of Europe, where the lower strata cannot rely on comprehensive government assistance, the hardships of life and the stresses they generate lead to a loss of faith in themselves and in the possibility of changes for the better among people with low status, resulting in psychological resources acting as a mediator of health social structuring.