Subjective Social Status as an Important Mediator in the Association Between Socioeconomic Status and Mental Health

Background and aims: Socioeconomic status (SES) is frequently seen as a significant indicator of mental health outcomes. This study aimed to determine the mediating role of subjective social status (SSS) in the association of SES and mental health among the employees of Tehran University of Medical Sciences (TUMS). Methods: This cross-sectional research involved the analysis of data collected from 4461 TUMS employees using a two-step structural equation modeling (SEM) approach. The study examined the impact of SES on mental health issues, specifically symptoms of depression, anxiety, and stress. SES was assessed as a composite index, and then each indicator was evaluated separately. SSS was considered as a potential mediator using the MacArthur scale, which was converted to a five-point Likert scale. The analysis utilized a two-step SEM approach in STATA version 14.0 with maximum likelihood estimation. Results: The majority of participants in the study were female (60.65%), and the mean (±SD) age of the participants was 42.21±8.72 years. The analysis revealed that the composite SES index had a standardized indirect effect of -0.05 on mental health through SSS. SSS accounted for 27.78% of the association between the composite SES index and mental health among TUMS employees (27.27% in males and 22.23% in females). Conclusion: The results of the study indicated that a lower SES may impact the development of mental health issues, indicating a relationship between SES and symptoms of depression, anxiety, and stress.