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Summary article Mulder, De Bruin, Schreurs, Van Ameijden, & Van Woerkum (2011)

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Summary of the article ‘Stressors and resources mediate the association of socioeconomic position with health behaviours’ from Mulder, De Bruin, Schreurs, Van Ameijden, & Van Woerkum (2011). This is reading material for week 2 of the course Advances in Health and Society at WUR, which is one of the compulsory courses in period 1 of the master MHS.

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Summary article ‘Stressors and resources mediate the association of
socioeconomic position with health behaviours’ – Mulder, De Bruin, Schreurs, Van
Ameijden, & Van Woerkum (2011)

Results: higher levels of stressors and lower levels of resources could be
represented by a single underlying factor, and co-occurred among those with
lower educational levels. Stressors and resources partially mediate the
relationship between education and four health-behaviours (exercise, breakfast
frequency, vegetable consumption and smoking). Financial stress and poor
perceived health status were mediating stressors, and social support a strong
mediating resource. An aggregate measure of the stressors and resources
showed similar associations with health behaviours compared to the summed
individual measures.

Conclusions: lower educated groups are simultaneously affected by the
presence of various stressors and absence of multiple resources, which partially
explain socioeconomic differences in health behaviours. Compared to the direct
associations of stressors and resources with health behaviours, the association
with socioeconomic status was modest. Therefore, interventions promoting
financial management, coping with chronic disease, and social skills training have
the potential to benefit large parts of the population, most notably the lower
educated.

Background
Indicators of socioeconomic position, such as education, occupation, income
and wealth, are negatively related to morbidity and mortality.
Previous research suggests that an important cause lies in the higher prevalence
of risky behaviours. The observation that socioeconomic position (SES) is
negatively correlated with morbidity, mortality and health behaviours suggests
that there is a set of common, general determinants of health behaviours that is
related to SES.
Stressors (e.g. financial stress, psychological distress, lack of psychosocial
resources) may group among those with lower SES.
- Here: financial stress, poor physical health and psychological distress.

At the other side of the balance a reserve capacity of several resources (e.g.
perceived control, social cohesion and social support) may positively impact
health behaviours.
- Perceived control: the belief that one has a certain degree of control
over the outcomes in one’s life determines emotional and behavioural
responses to negative events.
- Social support & cohesion: vary with measures of SES and provide
tangible, emotional or informational support when dealing with problems.

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