The Sequential Mediating Effects of Dietary Behavior and Perceived Stress on the Relationship between Subjective Socioeconomic Status and Multicultural Adolescent Health.

Youlim Kim,Kennedy Diema Konlan,Hyeonkyeong Lee,Sookyung Kim,Hyeyeon Lee,Mikyung Lee

doi:10.3390/ijerph18073604

Youlim Kim, Kennedy Diema Konlan + Show 4 more

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https://doi.org/10.3390/ijerph18073604

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Abstract

Studies have examined the impact of social determinants of health on the health behaviors and health statuses of ethnic minority adolescents. This study examines the subjective health of this population by examining the direct effects of multicultural adolescents’ subjective socioeconomic status (SES) and the sequential mediating effects of their dietary behaviors and perceived stress. We utilized secondary data of 500 middle school students from multicultural families who participated in the 15th Korean Youth Health Behavior Survey, 2019. Information about SES, perceived stress, subjective health status, and dietary behavior (measured by the breakfast intake frequency during the prior week) were utilized. For the relationship between the SES and the subjective health status, we confirmed the sequential mediating effects of breakfast frequency and perceived stress using SPSS 25.0 and PROCESS macro with bootstrapping. The results showed that SES had a direct effect on subjective health status and indirectly influenced subjective health status through the sequential mediating effect of breakfast frequency and perceived stress. However, SES had no direct effects on perceived stress. These findings emphasize that broadening the community-health lens to consider the upstream factor of SES when preparing health promotion interventions is essential to achieving health equity for vulnerable populations.

Highlights

Social determinants of health refer to the conditions necessary for living that influence health behaviors, such as adequate nutrition intake [1]
There was a positive correlation between the subjective socioeconomic status (SES) scores and the frequency of breakfast consumption and subjective health status, but it was not related to perceived stress
This study provides evidence to support the role of subjective SES of multicultural adolescents on their subjective health status and the indirect effect of mediating health behaviors, using a representative sample from national-level public data (15th Korea Youth Risk Behavior Survey (KYRBS))

Summary

Introduction

Social determinants of health refer to the conditions necessary for living that influence health behaviors, such as adequate nutrition intake [1]. Adolescent health is shaped by the interaction of social determinants of health as well as risk and protective factors affecting health behavior [5]. Socioeconomic status (SES) has long been identified as a strong determinant of adolescent health, and groups with low family SES generally exhibit lower health status, such as poor mental health and reduced wellbeing [6,7]. Family SES tends to have less influence on health among adolescents than for other age groups [7]; there is a lack of clarity regarding the relationship between family SES and adolescent health. Multicultural families in South Korea tend to be a vulnerable population, receiving various types of

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