Socioeconomic health disparities revisited: coping flexibility enhances health-related quality of life for individuals low in socioeconomic status

Abstract

Background: Previous research has generally indicated that disadvantaged socioeconomic groups tend to experience poor health-related quality of life (HRQoL). In an effort to extend the literature, this study proposes that coping flexibility is a stress buffer that mitigates the adverse effects of low socioeconomic status (SES).

Methods: The participants comprised 150 Indians (53 % women; mean age = 36.38 years) from high, medium and low socioeconomic groups. Their levels of perceived stress, coping flexibility, subjective SES and HRQoL were assessed individually through household interviews.

Results: The findings provide support for the hypothesised moderating role of coping flexibility between subjective SES and HRQoL (p < 0.001). In the low SES group, participants higher in coping flexibility reported significantly better HRQoL than those lower in coping flexibility. Moreover, coping flexibility moderated the association between perceived stress and HRQoL (p = 0.001). Of the participants who experienced higher levels of stress, those higher in coping flexibility reported better HRQoL than those lower in coping flexibility.

Conclusions: This study enriches the literature by revealing the beneficial role of coping flexibility on HRQoL among individuals low in SES. These new findings highlight the potential importance of psychological interventions that strengthen the flexible coping skills of socioeconomically disadvantaged groups.

Fig. 1

Moderation effects of coping flexibility (CF) on the relationship between subjective socioeconomic status (SES) and health-related quality of life (HRQoL). This graph shows that for participants having low subjective SES scores, those who displayed higher levels of coping flexibility reported significantly better HRQoL life than those who displayed lower coping flexibility (p < 0.001). There were no such differences for participants having high subjective SES scores (p = 0.55)

Fig. 2

Moderation effects of coping flexibility (CF) on the relationship between perceived stress and HRQoL. This graph shows that for participants who exhibited less coping flexibility, those who perceived higher stress levels reported significantly lower HRQoL than others who perceived less stress levels (p < 0.001). No such differences in HRQoL were revealed for participants who displayed higher levels of coping flexibility (p = 0.43)