The Mediating Roles of Perceived Stress and Health Behaviors in the Relation Between Objective, Subjective, and Neighborhood Socioeconomic Status and Perceived Health

Objective, subjective, and neighborhood socioeconomic status (SES) are associated with perceived health, morbidity, and mortality. We investigated whether perceived stress and health behaviors mediated the relation between the three types of SES and perceived health. Participants (N = 508) attending a public clinic completed a computerized survey assessing objective SES (income, education, employment); health behaviors; perceived stress; and perceived health. They also indicated their social standing relative to others (subjective SES) and provided their current address to determine neighborhood SES. In a structural equation model including all three SES types, lower objective and subjective SES were related to poorer perceived health. When mediators were included in the model, there were significant indirect effects of (a) SES on health through stress and (b) SES on health through stress and health-compromising behaviors. Interventions to reduce the impact of stressors could improve the health of socioeconomically disadvantaged individuals.