Skip to main content
Top
Published in: Health and Quality of Life Outcomes 1/2016

Open Access 01-12-2016 | Research

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

Authors: Saloni Atal, Cecilia Cheng

Published in: Health and Quality of Life Outcomes | Issue 1/2016

Login to get access

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.
Literature
2.
go back to reference Baum A, Garofalo JP, YALI A. Socioeconomic status and chronic stress: does stress account for SES effects on health? Ann N Y Acad Sci. 1999;896:131–44.PubMedCrossRef Baum A, Garofalo JP, YALI A. Socioeconomic status and chronic stress: does stress account for SES effects on health? Ann N Y Acad Sci. 1999;896:131–44.PubMedCrossRef
3.
go back to reference Chen E, Strunk RC, Trethewey A, Schreier HM, Maharaj N, Miller GE. Resilience in low-socioeconomic-status children with asthma: adaptations to stress. J Allergy Clin Immunol. 2011;128:970–6.PubMedPubMedCentralCrossRef Chen E, Strunk RC, Trethewey A, Schreier HM, Maharaj N, Miller GE. Resilience in low-socioeconomic-status children with asthma: adaptations to stress. J Allergy Clin Immunol. 2011;128:970–6.PubMedPubMedCentralCrossRef
4.
go back to reference Bonanno GA. Resilience in the face of potential trauma. Curr Dir Psychol Sci. 2005;14:135–8.CrossRef Bonanno GA. Resilience in the face of potential trauma. Curr Dir Psychol Sci. 2005;14:135–8.CrossRef
5.
go back to reference Cohen S, Doyle WJ, Turner RB, Alper CM, Skoner DP. Childhood socioeconomic status and host resistance to infectious illness in adulthood. Psychosom Med. 2004;66:553–8.PubMedCrossRef Cohen S, Doyle WJ, Turner RB, Alper CM, Skoner DP. Childhood socioeconomic status and host resistance to infectious illness in adulthood. Psychosom Med. 2004;66:553–8.PubMedCrossRef
6.
go back to reference Adler NE, Snibbe AC. The role of psychosocial processes in explaining the gradient between socioeconomic status and health. Curr Dir Psychol Sci. 2003;12:119–23.CrossRef Adler NE, Snibbe AC. The role of psychosocial processes in explaining the gradient between socioeconomic status and health. Curr Dir Psychol Sci. 2003;12:119–23.CrossRef
8.
go back to reference Ouwehand C, de Ridder DT, Bensing JM. Who can afford to look to the future? The relationship between socio-economic status and proactive coping. Eur J Public Health. 2009;19:412–7.PubMedCrossRef Ouwehand C, de Ridder DT, Bensing JM. Who can afford to look to the future? The relationship between socio-economic status and proactive coping. Eur J Public Health. 2009;19:412–7.PubMedCrossRef
10.
go back to reference Taylor SE, Stanton AL. Coping resources, coping processes, and mental health. Annu Rev Clin Psychol. 2007;3:377–401.PubMedCrossRef Taylor SE, Stanton AL. Coping resources, coping processes, and mental health. Annu Rev Clin Psychol. 2007;3:377–401.PubMedCrossRef
11.
go back to reference Folkman S. The case for positive emotions in the stress process. Anxiety Stress Coping. 2008;21:3–14.PubMedCrossRef Folkman S. The case for positive emotions in the stress process. Anxiety Stress Coping. 2008;21:3–14.PubMedCrossRef
12.
go back to reference Cheng C, Lau H-PB, Chan M-PS. Coping flexibility and psychological adjustment to stressful life changes: a meta-analytic review. 2014. Cheng C, Lau H-PB, Chan M-PS. Coping flexibility and psychological adjustment to stressful life changes: a meta-analytic review. 2014.
13.
go back to reference Bonanno GA, Burton CL. Regulatory flexibility: an individual differences perspective on coping and emotion regulation. Perspect Psychol Sci. 2013;8:591–612.PubMedCrossRef Bonanno GA, Burton CL. Regulatory flexibility: an individual differences perspective on coping and emotion regulation. Perspect Psychol Sci. 2013;8:591–612.PubMedCrossRef
14.
go back to reference Kato T. Testing of the coping flexibility hypothesis based on the dual-process theory: Relationships between coping flexibility and depressive Symptoms. Psychiatry Res. 2015. Kato T. Testing of the coping flexibility hypothesis based on the dual-process theory: Relationships between coping flexibility and depressive Symptoms. Psychiatry Res. 2015.
15.
go back to reference Baker JP, Berenbaum H. Emotional approach and problem-focused coping: a comparison of potentially adaptive strategies. Cogn Emot. 2007;21:95–118.CrossRef Baker JP, Berenbaum H. Emotional approach and problem-focused coping: a comparison of potentially adaptive strategies. Cogn Emot. 2007;21:95–118.CrossRef
16.
go back to reference Cheng C, Chan N, Chio JH, Chan P, Chan AO, Hui W. Being active or flexible? Role of control coping on quality of life among patients with gastrointestinal cancer. Psychooncology. 2012;21:211–8.PubMedCrossRef Cheng C, Chan N, Chio JH, Chan P, Chan AO, Hui W. Being active or flexible? Role of control coping on quality of life among patients with gastrointestinal cancer. Psychooncology. 2012;21:211–8.PubMedCrossRef
17.
go back to reference Meyer IH, Schwartz S, Frost DM. Social patterning of stress and coping: does disadvantaged social statuses confer more stress and fewer coping resources? Soc Sci Med. 2008;67:368–79.PubMedPubMedCentralCrossRef Meyer IH, Schwartz S, Frost DM. Social patterning of stress and coping: does disadvantaged social statuses confer more stress and fewer coping resources? Soc Sci Med. 2008;67:368–79.PubMedPubMedCentralCrossRef
18.
go back to reference Chen E, Miller GE, Lachman ME, Gruenewald TL, Seeman TE. Protective factors for adults from low childhood socioeconomic circumstances: the benefits of shift-and-persist for allostatic load. Psychosom Med. 2012;74:178.PubMedPubMedCentralCrossRef Chen E, Miller GE, Lachman ME, Gruenewald TL, Seeman TE. Protective factors for adults from low childhood socioeconomic circumstances: the benefits of shift-and-persist for allostatic load. Psychosom Med. 2012;74:178.PubMedPubMedCentralCrossRef
19.
go back to reference Gallo LC, de los Monteros KE, Shivpuri S. Socioeconomic status and health what is the role of reserve capacity? Curr Dir Psychol Sci. 2009;18:269–74.PubMedPubMedCentralCrossRef Gallo LC, de los Monteros KE, Shivpuri S. Socioeconomic status and health what is the role of reserve capacity? Curr Dir Psychol Sci. 2009;18:269–74.PubMedPubMedCentralCrossRef
20.
go back to reference Fredrickson BL, Tugade MM, Waugh CE, Larkin GR. What good are positive emotions in crisis? A prospective study of resilience and emotions following the terrorist attacks on the United States on September 11th, 2001. J Pers Soc Psychol. 2003;84:365.PubMedPubMedCentralCrossRef Fredrickson BL, Tugade MM, Waugh CE, Larkin GR. What good are positive emotions in crisis? A prospective study of resilience and emotions following the terrorist attacks on the United States on September 11th, 2001. J Pers Soc Psychol. 2003;84:365.PubMedPubMedCentralCrossRef
21.
go back to reference Benotsch EG, Brailey K, Vasterling JJ, Uddo M, Constans JI, Sutker PB. War zone stress, personal and environmental resources, and PTSD symptoms in Gulf War veterans: a longitudinal perspective. J Abnorm Psychol. 2000;109:205.PubMedCrossRef Benotsch EG, Brailey K, Vasterling JJ, Uddo M, Constans JI, Sutker PB. War zone stress, personal and environmental resources, and PTSD symptoms in Gulf War veterans: a longitudinal perspective. J Abnorm Psychol. 2000;109:205.PubMedCrossRef
22.
go back to reference Park M, Chang ER, You S. Protective role of coping flexibility in PTSD and depressive symptoms following trauma. Personal Individ Differ. 2015;82:102–6.CrossRef Park M, Chang ER, You S. Protective role of coping flexibility in PTSD and depressive symptoms following trauma. Personal Individ Differ. 2015;82:102–6.CrossRef
23.
go back to reference Kraus MW, Keltner D. Social class rank, essentialism, and punitive judgment. J Pers Soc Psychol. 2013;105:247.PubMedCrossRef Kraus MW, Keltner D. Social class rank, essentialism, and punitive judgment. J Pers Soc Psychol. 2013;105:247.PubMedCrossRef
24.
go back to reference Wolff LS, Acevedo-Garcia D, Subramanian SV, Weber D, Kawachi I. Subjective social status, a new measure in health disparities research: do race/ethnicity and choice of referent group matter? J Health Psychol. 2010;15:560–74.PubMedCrossRef Wolff LS, Acevedo-Garcia D, Subramanian SV, Weber D, Kawachi I. Subjective social status, a new measure in health disparities research: do race/ethnicity and choice of referent group matter? J Health Psychol. 2010;15:560–74.PubMedCrossRef
25.
go back to reference Cheng C, Hui W, Lam S. Coping style of individuals with functional dyspepsia. Psychosom Med. 1999;61:789–95.PubMedCrossRef Cheng C, Hui W, Lam S. Coping style of individuals with functional dyspepsia. Psychosom Med. 1999;61:789–95.PubMedCrossRef
26.
go back to reference Cheng C. Dialectical thinking and coping flexibility: a multimethod approach. J Pers. 2009;77:471–94.PubMedCrossRef Cheng C. Dialectical thinking and coping flexibility: a multimethod approach. J Pers. 2009;77:471–94.PubMedCrossRef
27.
go back to reference Gan Y, Zhang Y, Wang X, Wang S, Shen X. The coping flexibility of neurasthenia and depressive patients. Personal Individ Differ. 2006;40:859–71.CrossRef Gan Y, Zhang Y, Wang X, Wang S, Shen X. The coping flexibility of neurasthenia and depressive patients. Personal Individ Differ. 2006;40:859–71.CrossRef
28.
go back to reference Lyman GH. Guidelines of the national comprehensive cancer network on the use of myeloid growth factors with cancer chemotherapy: a review of the evidence. J Natl Compr Canc Netw. 2005;3:557–71.PubMed Lyman GH. Guidelines of the national comprehensive cancer network on the use of myeloid growth factors with cancer chemotherapy: a review of the evidence. J Natl Compr Canc Netw. 2005;3:557–71.PubMed
29.
go back to reference Tang L, Zhang Y, Pang Y, Zhang H, Song L. Validation and reliability of distress thermometer in Chinese cancer patients. Chin J Cancer Res. 2011;23:54–8.PubMedPubMedCentralCrossRef Tang L, Zhang Y, Pang Y, Zhang H, Song L. Validation and reliability of distress thermometer in Chinese cancer patients. Chin J Cancer Res. 2011;23:54–8.PubMedPubMedCentralCrossRef
30.
go back to reference Adler NE, Epel ES, Castellazzo G, Ickovics JR. Relationship of subjective and objective social status with psychological and physiological functioning: preliminary data in healthy, white women. Health Psychol. 2000;19:586.PubMedCrossRef Adler NE, Epel ES, Castellazzo G, Ickovics JR. Relationship of subjective and objective social status with psychological and physiological functioning: preliminary data in healthy, white women. Health Psychol. 2000;19:586.PubMedCrossRef
31.
go back to reference Giatti L, do Valle Camelo L, de Castro Rodrigues JF, Barreto SM. Reliability of the MacArthur scale of subjective social status-Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). BMC Public Health. 2012;12:1096.PubMedPubMedCentralCrossRef Giatti L, do Valle Camelo L, de Castro Rodrigues JF, Barreto SM. Reliability of the MacArthur scale of subjective social status-Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). BMC Public Health. 2012;12:1096.PubMedPubMedCentralCrossRef
32.
go back to reference Cundiff JM, Smith TW, Uchino BN, Berg CA. Subjective social status: construct validity and associations with psychosocial vulnerability and self-rated health. Int J Behav Med. 2013;20:148–58.PubMedCrossRef Cundiff JM, Smith TW, Uchino BN, Berg CA. Subjective social status: construct validity and associations with psychosocial vulnerability and self-rated health. Int J Behav Med. 2013;20:148–58.PubMedCrossRef
33.
go back to reference Turner-Bowker DM, Bayliss MS, Ware Jr JE, Kosinski M. Usefulness of the SF-8™ Health Survey for comparing the impact of migraine and other conditions. Qual Life Res. 2003;12:1003–12.PubMedCrossRef Turner-Bowker DM, Bayliss MS, Ware Jr JE, Kosinski M. Usefulness of the SF-8™ Health Survey for comparing the impact of migraine and other conditions. Qual Life Res. 2003;12:1003–12.PubMedCrossRef
34.
go back to reference Roberts B, Damundu EY, Lomoro O, Sondorp E. The influence of demographic characteristics, living conditions, and trauma exposure on the overall health of a conflict-affected population in Southern Sudan. BMC Public Health. 2010;10:518.PubMedPubMedCentralCrossRef Roberts B, Damundu EY, Lomoro O, Sondorp E. The influence of demographic characteristics, living conditions, and trauma exposure on the overall health of a conflict-affected population in Southern Sudan. BMC Public Health. 2010;10:518.PubMedPubMedCentralCrossRef
35.
go back to reference Tokuda Y, Okubo T, Ohde S, Jacobs J, Takahashi O, Omata F, et al. Assessing items on the SF-8 Japanese version for health-related quality of life: a psychometric analysis based on the nominal categories model of item response theory. Value Health. 2009;12:568–73.PubMedCrossRef Tokuda Y, Okubo T, Ohde S, Jacobs J, Takahashi O, Omata F, et al. Assessing items on the SF-8 Japanese version for health-related quality of life: a psychometric analysis based on the nominal categories model of item response theory. Value Health. 2009;12:568–73.PubMedCrossRef
36.
go back to reference Cheng C. Cognitive and motivational processes underlying coping flexibility: a dual-process model. J Pers Soc Psychol. 2003;84:425.PubMedCrossRef Cheng C. Cognitive and motivational processes underlying coping flexibility: a dual-process model. J Pers Soc Psychol. 2003;84:425.PubMedCrossRef
37.
go back to reference Schmidt S, Nachtigall C, Wuethrich-Martone O, Strauss B. Attachment and coping with chronic disease. J Psychosom Res. 2002;53:763–73.PubMedCrossRef Schmidt S, Nachtigall C, Wuethrich-Martone O, Strauss B. Attachment and coping with chronic disease. J Psychosom Res. 2002;53:763–73.PubMedCrossRef
38.
go back to reference Stephens NM, Markus HR, Townsend SS. Choice as an act of meaning: the case of social class. J Pers Soc Psychol. 2007;93:814.PubMedCrossRef Stephens NM, Markus HR, Townsend SS. Choice as an act of meaning: the case of social class. J Pers Soc Psychol. 2007;93:814.PubMedCrossRef
39.
go back to reference Cheng C. Assessing coping flexibility in real-life and laboratory settings: a multimethod approach. J Pers Soc Psychol. 2001;80:814.PubMedCrossRef Cheng C. Assessing coping flexibility in real-life and laboratory settings: a multimethod approach. J Pers Soc Psychol. 2001;80:814.PubMedCrossRef
40.
go back to reference Morozink JA, Friedman EM, Coe CL, Ryff CD. Socioeconomic and psychosocial predictors of interleukin-6 in the MIDUS national sample. Health Psychol. 2010;29:626.PubMedPubMedCentralCrossRef Morozink JA, Friedman EM, Coe CL, Ryff CD. Socioeconomic and psychosocial predictors of interleukin-6 in the MIDUS national sample. Health Psychol. 2010;29:626.PubMedPubMedCentralCrossRef
41.
go back to reference Lachman ME, Weaver SL. The sense of control as a moderator of social class differences in health and well-being. J Pers Soc Psychol. 1998;74:763.PubMedCrossRef Lachman ME, Weaver SL. The sense of control as a moderator of social class differences in health and well-being. J Pers Soc Psychol. 1998;74:763.PubMedCrossRef
42.
go back to reference Stroebe M, Schut H. The dual process model of coping with bereavement: a decade on. OMEGA-J Death Dying. 2010;61:273–89.CrossRef Stroebe M, Schut H. The dual process model of coping with bereavement: a decade on. OMEGA-J Death Dying. 2010;61:273–89.CrossRef
43.
go back to reference Adler NE, Newman K. Socioeconomic disparities in health: pathways and policies. Health Aff (Millwood). 2002;21:60–76.CrossRef Adler NE, Newman K. Socioeconomic disparities in health: pathways and policies. Health Aff (Millwood). 2002;21:60–76.CrossRef
44.
go back to reference Gallo LC, Matthews KA. Understanding the association between socioeconomic status and physical health: do negative emotions play a role? Psychol Bull. 2003;129:10.PubMedCrossRef Gallo LC, Matthews KA. Understanding the association between socioeconomic status and physical health: do negative emotions play a role? Psychol Bull. 2003;129:10.PubMedCrossRef
45.
go back to reference Cheng C, Yang F-C, Jun S, Hutton JM. Flexible coping psychotherapy for functional dyspeptic patients: a randomized, controlled trial. Psychosom Med. 2007;69:81–8.PubMedCrossRef Cheng C, Yang F-C, Jun S, Hutton JM. Flexible coping psychotherapy for functional dyspeptic patients: a randomized, controlled trial. Psychosom Med. 2007;69:81–8.PubMedCrossRef
46.
go back to reference Cheng C, Kogan A, Chio JH. The effectiveness of a new, coping flexibility intervention as compared with a cognitive-behavioural intervention in managing work stress. Work Stress. 2012;26:272–88.CrossRef Cheng C, Kogan A, Chio JH. The effectiveness of a new, coping flexibility intervention as compared with a cognitive-behavioural intervention in managing work stress. Work Stress. 2012;26:272–88.CrossRef
47.
go back to reference Popa B, Guillet L, Mullet E. Cultural differences in the appraisal of stress. Psicológica. 2014;35:745–60. Popa B, Guillet L, Mullet E. Cultural differences in the appraisal of stress. Psicológica. 2014;35:745–60.
48.
go back to reference Chun C-A, Moos RH, Cronkite RC. Culture: a fundamental context for the stress and coping paradigm. In: Handbook of multicultural perspectives on stress and coping. Dallas, Texas: Springer; 2006. p. 29–53. Chun C-A, Moos RH, Cronkite RC. Culture: a fundamental context for the stress and coping paradigm. In: Handbook of multicultural perspectives on stress and coping. Dallas, Texas: Springer; 2006. p. 29–53.
Metadata
Title
Socioeconomic health disparities revisited: coping flexibility enhances health-related quality of life for individuals low in socioeconomic status
Authors
Saloni Atal
Cecilia Cheng
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2016
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/s12955-016-0410-1

Other articles of this Issue 1/2016

Health and Quality of Life Outcomes 1/2016 Go to the issue