Socioeconomic inequalities in health: the role of daily hassles and the importance of health

• Published in: European journal of public health 2021-10, Vol.31 (Supplement_3)
• Main Authors: Verra, SE, Poelman, MP, Mudd, AL, de Vet, E, de Wit, J, Kamphuis, CBM
• Format: Article
• Language: English
• Subjects: Adults; Educational inequality; Health; Housing; Income inequality; Legal issues; Multivariate statistical analysis; Public health; Socioeconomic factors; Socioeconomics; Structural equation modeling
• ISSN: 1101-1262; 1464-360X
• DOI: 10.1093/eurpub/ckab164.369

A low socioeconomic position (SEP) adversely affects health outcomes and is associated with a lower perceived importance of health. It has been suggested that people with a low SEP disproportionately face daily hassles, as a result of which health may be perceived as less important for those with a low SEP compared to those with a high SEP. A lower perceived importance of health likely influences health-related behaviours that affect health outcomes. This study examines whether socioeconomic inequalities in self-assessed health are mediated by daily hassles and/or the perceived importance of health, and whether there is sequential mediation of daily hassles and perceived importance of health. A cross-sectional survey was conducted in 2019 among N = 1,334 Dutch adults. Participants rated the extent of eleven commonly experienced daily hassles (e.g., financial hassles, legal issues), and indicated the perceived importance of two health-related domains (not being ill, living a long life). Inequalities in self-assessed health according to SEP (indicated by income and education) were examined using structural equation modelling, with daily hassles and perceived importance of not being ill or living long a life either as single or sequential mediators. Daily hassles and perceived importance of health individually mediated the relationship between SEP and self-assessed health, but importance of health did not mediate the association between by daily hassles self-assessed health. Socioeconomic inequalities in self-assessed health were explained by the experience of daily hassles, and by differences in the perceived importance of health individually, but the perceived importance of health did not explain the influence of the experience of daily hassles. Addressing the challenging circumstances (e.g., financial or housing hassles) associated with a low SEP, may contribute to improving self-assessed health. Further research should examine how daily hassles affect health. Key messages Daily hassles and the perceived importance of health mediated the relationship between socioeconomic position and health. There was no association between daily hassles and the perceived importance of health.