UBC Theses and Dissertations
Social determinants of self-rated health : the interaction of gender with socioeconomic status and social relationships in the Yukon Jeffery, Bonnie Lynn
This study addressed the social determinants of health with a specific focus on three factors in the social environment that either individually or collectively have an influence on health status: gender, socioeconomic status (SES), and people's social relationships. The purpose of the study was to examine whether people's social relationships mediate the effects of SES on self-rated health status and to assess whether these effects differ for women and men. The research questions were examined by formulating a theoretical model and evaluating the hypothesized relationships through the use of structural equation modelling. The analyses were conducted using LISREL on data from 1,239 non-First Nations Yukon residents who participated in the Territory's 1993 Health Promotion Survey. The results of this study suggest that household income significantly affected women's and men's health by influencing aspects of their social relationships. A higher overall rating of the quality of one's social relationships was associated with positive health ratings for both women and men while the perception that support would be available if needed significantly affected only women's self-ratings of their health. Received social support was negatively associated with women's health, but not men's, suggesting that the context in which support is received has an important influence on women's health. Relationship strain, as measured by care provided to several sources, was not significantly related to women's or men's health-ratings. The analyses also identify important interrelationships among the dimensions of social relationships studied as well as some gender differences among these relationships. For both women and men, positive evaluations of the importance of social relationships for their health and a greater number of social ties significantly influenced ratings of the overall quality of their social relationships. Having more social ties also positively influenced the perception of availability of social support for both women and men. The quality of their social relationships influenced the perceived availability of social support only for women. Given the focus of provincial and federal governments in seeking reform of their health-care systems, attention to modifiable determinants of health presents an opportunity to contribute to this reform process. The findings of this study contribute to our understanding of the effects of SES on health by providing support for gender interactions in a set of relationships where aspects of people's social relationships mediate the effects of income on health status. These findings provide support for gender-specific mechanisms by which income level influences perceived health status by shaping people's social relationships, the quality of those relationships and the support they offer.
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