Social inequalities in mental health: Exploring the mediating role of psychosocial resources in individuals with spinal cord injury.

OBJECTIVE

Lower mental health was observed in individuals with lower socioeconomic position (SES) in the general population. Similarly, social inequalities in mental health have also been observed in individuals with spinal cord injury (SCI), however, there is limited knowledge of the nonbiological mechanisms contributing to this uneven distribution. Previous research has demonstrated that psychosocial resources are linked to improved mental health. The aims of the present study were (a) to investigate the direct effects between SES and mental health load and (b) the mediating role of psychosocial resources in the SES mental health load associations in individuals living with SCI.

RESEARCH METHOD: Cross-sectional self-report data from N = 1,294 persons living with SCI from the Swiss Spinal Cord Injury Cohort study were analyzed using structural equation modeling. SES was operationalized by education, household income, perceived financial hardship, and subjective social status. Psychosocial resources were operationalized by self-esteem, self-efficacy, hope, optimism and energy, feeling of belonging, purpose in life, social support, and relationship satisfaction. Mental health load was operationalized by emotional state, depressive symptoms, psychological distress, and affective components of well-being.

RESULTS

Higher SES was significantly associated with lower mental health load. Self-esteem, self-efficacy, optimism and energy, feeling of belonging, purpose in life, and relationship satisfaction were found to mediate the association between SES and mental health load.

CONCLUSION

The study underscores potential interventions to address socioeconomic inequalities in mental health load among individuals living with SCI. Strengthening psychosocial resources could offer promising interventions, particularly for those from low SES backgrounds facing mental health challenges. (PsycInfo Database Record (c) 2025 APA, all rights reserved).