Health literacy and subjective well-being: A moderated mediation model of social network and mental health in a Chinese cross-sectional national survey.

BACKGROUND

Current evidence lacks conclusive understanding of the integrated pathways linking health literacy, mental health, social network, and subjective well-being (SWB). This study aims to address this critical gap by investigating the complex interplay among these factors to advance strategies for enhancing population SWB.

METHODS

This study was conducted in China using a multi-stage random sampling method in 2021, and included 30,504 individuals aged ≥12 years from the general population for a cross-sectional survey. Bootstrap analysis was used to examine the mediating effects of mental health and social network, while hierarchical regression was applied to test the moderating role of mental health.

RESULTS

Mental health demonstrated significant mediation between health literacy and SWB index (anxiety: β = 0.031, 95 % CI = [0.027, 0.035], p < 0.001; depression: β = 0.029, 95 % CI = [0.025, 0.033], p < 0.001). Social network also showed a significant mediating effect in the relationship between health literacy and SWB index (β = 0.018, 95 % CI = [0.016, 0.020], p < 0.001). Furthermore, mental health exhibited a significant moderating effect between social network and SWB index (anxiety: β = -0.098, 95 % CI = [-0.110, -0.086], p < 0.001; depression: β = -0.100, 95 % CI = [-0.112, -0.088], p < 0.001).

CONCLUSIONS

Mental health and social network partially mediate the relationship between health literacy and SWB, while mental health also positively moderates the relationship between social network and SWB. Enhancing mental health status and expanding social network are crucial for improving SWB through health literacy promotion.