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Health Education & Behavior
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Mechanisms of Psychosocial Effects on Health: The Role of Social Integration, Coping Style and Health Behavior

Julie M. Goldsmith Cwikel, PhD

Institute of Gerontology and Adult Human Development, Jerusalem, Israel

Ted E. Dielman, PhD

Department of Postgraduate Medicine and Health Professions Education, University of Michigan Medical School, Department of Health Behavior and Health Education, University of Michigan School of Public Health

John P. Kirscht, PhD

Health Behavior and Health Education, University of Michigan School of Public Health

Barbara A. Israel, DrPH

Health Behavior and Health Education, University of Michigan School of Public Health

To analyze the mechanisms by which psychosocial factors affect health, this re search investigated social integration and indicators of coping style and their relation to health behaviors and health status. The analysis was conducted using the results of a 1977 survey of 854 household interviews from a multi-stage probability sample of adult residents of Washtenaw County, Michigan. Physical-health status was evaluated by two indices: Self-rated global health and self reports of chronic disability. Mental health was assessed with the Center for Epidemiologic Studies Depression Scale. Over all, the effects of the psychosocial factors were stronger for mental health than physi cal health. Social integration was shown to have direct effects on both physical and mental-health status. Internal locus of control was associated with lower levels of de pressive symptoms. Chronic conditions were primarily affected by age, sex, and health behavior. Evidence from the path analyses suggested that part of the health benefit that women accrue from social integration and an active coping style is related to better health behavior. This mediation effect was not found for men.

Health Education & Behavior, Vol. 15, No. 2, 151-173 (1988)
DOI: 10.1177/109019818801500202
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