Distinguishing independent and shared effects of material/structural conditions and psychosocial resources on educational inequalities in self-rated health: results from structural equation modelling.
OBJECTIVES
The aim of this study was to distinguish independent and shared effects of material/structural factors and psychosocial resources in explaining educational inequalities in self-rated health (SRH) by using structural equation modelling.


STUDY DESIGN
Cross-sectional survey.


METHODS
Data were derived from a questionnaire sent to a random sample of the population in five counties in Sweden in 2008. The study population (aged 25-75 years) included 15,099 men and 17,883 women. Exploratory structural equation modelling was used to analyse the pathways from educational level to SRH.


RESULTS
The pathway including both material/structural factors (e.g. financial buffer and unemployment) and psychosocial resources (e.g. sense of coherence and social participation) explained about 40% of educational differences in SRH for both men and women. The pathways including only the independent effects of psychosocial resources (14% in men and 20% in women) or material/structural factors (9% and 18%, respectively) explained substantial but smaller proportions of the differences.


CONCLUSIONS
The major pathway explaining educational inequalities in SRH included both material/structural factors and psychosocial resources. Therefore, to reduce educational inequalities in SRH, interventions need to address both material/structural conditions and psychosocial resources across educational groups.
['Granström|F|F|', 'Garvin|P|P|', 'Molarius|A|A|', 'Kristenson|M|M|']
D003430:Cross-Sectional Studies D004522:Educational Status D005260:Female D054624:Health Status Disparities D006801:Humans D000077272:Latent Class Analysis D008297:Male D012959:Socioeconomic Factors
Inequalities Sweden Educational status Health status Psychosocial factors