A Study On The Relationship Between Socioeconomic Status And Health Of Young And Middle-Aged Populations And The Mediating Role Of Stress

Objective This study aims to analyze the socioeconomic status of young people,stress and health status and health impact factors,explore the relationship between social and economic status,stress and health,as well as the mediation effect of stress in social and financial status and well-being,to mitigate the stress status of residents and improve health.Methods This study initially conducted a literature analysis to construct a theoretical framework model of socioeconomic status and health.Based on this,an current survey was conducted.A total of 2465 young and middle-aged residents in Hangzhou and Quzhou were selected for the questionnaire using a multistage sampling method.The questionnaire included information on residents’ socioeconomic status,the Short Form Health Survey(SF12),the Self-Rated Health Scale and the Chinese version of the Perceptual Stress Scale(CPSS).Principal component analysis and latent class analysis were used to calculate SES values(PCA method)and SES categories(LCA method),respectively,and to conduct correlation analysis of subjective and objective socioeconomic status,respectively.Multiple linear regression models were used to examine the relationships between socioeconomic status,stress and health separately.Finally,a mediation analysis theoretical model was constructed to analyse the relationship between stress in socioeconomic status and health.Main results 1.The SES score(PCA method)of the residents in this study was(0.11±0.98);the low SES category(LCA method)accounted for 62.98%,and those with general subjective SES accounted for 74.77%.The mean physical,mental and self-rated health scores were(49.88±8.06),(46.47±5.49)and(78.45±13.15)for young and middle-aged adults in the two regions of Zhejiang,respectively.2.The higher the socioeconomic status,the better the health status of the young and middleaged population.Among them,the higher the SES score(PCA method),the higher the selfrated health score(β=1.40,95%CI:0.88,1.92,P<0.001).The effect of medium and high SES categories on self-rated health was statistically significant compared to low SES category(β=1.88,95%CI:0.49,3.27,P<0.001;β=2.20,95%CI:0.92,3.49,P=0.008).Compared with low subjective SES,self-rated health scores were higher in general subjective SES and high subjective SES middle-aged and young adults(β=4.44,95%CI:2.75,6.13,P<0.01;β=7.72,95%CI:5.68,9.76,P<0.001).4.The young and middle-aged population with stress had worse health status.Respondents with stress have poorer physical,psychological and self-rated health status than those without stress(β=-1.33,95%CI:-1.92,-0.73,P<0.001;β=-3.24,95%CI:-3.67,-2.80,P<0.001;β=-3.63,95%CI:-4.66,-2.61,P<0.001).5.Stress mediated the effect between SES and health.After adjusting for confounding variables,the percentage mediation effects of stress between SES scores(PCA method)and physical,psychological,and self-rated health were 7.83%,37.53%,and 14.68%,respectively.The percentages of mediating effects between stress in the middle SES category(LCA method)and physical,psychological and self-rated health were 24.59%,30.40%and 11.35%respectively,compared to those in the low SES category.The percentages of mediating effects of stress between high SES category(LCA method)and physical,psychological,and selfrated health were 9.42%,36.17%,and 22.35%,respectively,relative to those in the low SES category.Relative to those with low subjective SES,the percentages of mediating effects of general subjective SES through stress on physical,psychological and self-rated health were 8.91%,25.33%and 10.46%,respectively.Compared to those with low subjective SES,the percentages of mediating effects of high subjective SES through stress on physiological,psychological,and self-rated health were 14.29%,36.26%,and 9.64%,respectively.Conclusion 1.There is still potential for improvement in the socioeconomic status of young and middle-aged people in the two prefectures of Zhejiang Province.2.Those with higher socioeconomic status have higher health scores.3.The higher objective and subjective socioeconomic status of young and middle-aged people can contribute to health through stress.