Relationships between psychological distress and health behaviors among Canadian adults: Differences based on gender, income, education, immigrant status, and ethnicity

Abstract

Objective: Psychosocial health predicts physical health outcomes in both clinical samples and the general population. One mechanism is through relationships with health behaviors. Results might differ based on sociodemographic characteristics such as education, income, ethnicity, and immigrant status. Our objective was to analyze sociodemographic differences in relationships between psychosocial health measures and health behaviors in the general population of Canadian adults.

Methods: We analyzed relationships between non-specific psychological distress, assessed using the Kessler-10 scale, and five key health behaviors: fruit and vegetable intake, screen sedentary behavior, physical activity, alcohol consumption, and cigarette use. Data were collected by Statistics Canada for the Canadian Community Health Survey in 2011-2014. Our sample included 54,789 participants representative of 14,555,346 Canadian adults. We used univariate general linear models on the weighted sample to analyze relationships between distress (predictor) and each health behavior, controlling for age. We entered sex and one of four sociodemographic variable of interest (education, income, ethnicity, immigrant status) into each model to analyze gender and sociodemographic differences in relationships.

Results: Greater distress predicted less fruit and vegetable intake and physical activity, and greater screen sedentary behavior and cigarette use, in the full sample, with small effect sizes (partial η² up to 0.013). Differences by gender and sociodemographic characteristics were evident for all health behaviors.

Conclusions: Psychosocial health might contribute to persistent socioeconomic disparities in health in part through relationships with health behaviors, although relationships in the general population are modest. Health behavior interventions incorporating psychosocial health might need to be tailored based on socioeconomic characteristics, and future research on intersections between multiple sociodemographic risk factors remains necessary.

Keywords: Diet; Health disparities; Mental health; Physical activity; Psychosocial health; Smoking.

Fig. 1

Relationships between distress and daily servings of fruit and vegetables. Distress = K10 Score, ranging from 0 (low) to 10 (high).

Fig. 2

Relationships between distress and hours per week of leisure-time screen sedentary behavior. Distress = K10 Score, ranging from 0 (low) to 10 (high).

Fig. 3

Relationships between distress and weekly frequency of physical activities >15 min. Distress = K10 Score, ranging from 0 (low) to 10 (high).

Fig. 4

Relationships between distress and daily consumption of alcohol. Distress = K10 Score, ranging from 0 (low) to 10 (high).

Fig. 5

Relationships between distress and cigarettes per day. Distress = K10 Score, ranging from 0 (low) to 10 (high).