ArticleAmerican journal of hypertension2024
Lower Socioeconomic Status, Psychological Distress, and Self-reported Hypertension: A Longitudinal Moderated Mediation Analysis.
Article in American journal of hypertension, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 10 citations in OpenAlex.
- Lower socioeconomic status strengthens the risk of otitis media with effusion after COVID-19 infection: a case-crossover study in Northeast China.Scientific reports · 2026Article
- A National Dyadic Study of Spousal Education and Hypertension Among Older Couples in the United States.Research on aging · 2025Article
- The impact of marital status on hypertension: SEM analysis of a Chinese general population cohort.BMC public health · 2025Article
- Psychological distress and its association with gender, socioeconomic status, education and health conditions.Scientific reports · 2025Article
- Social Determinants of Health, Blood Pressure Classification, and Incident Stroke Among Chinese Adults.JAMA network open · 2024Article
- The social status adversity and health in daily life moments study: ecological momentary assessment and ambulatory health assessments to examine meaning and mechanisms.BMC psychology · 2024Article
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundLower socioeconomic status (SES) has been associated with hypertension; however, the mediators and moderators of this association remain understudied. We examined the mediation effect of psychological distress on the link between lower SES and self-reported hypertension and the racial and sex moderation effects.
methodsWe analyzed the data collected from 2009 to 2019 among adults from the Panel Study of Income Dynamics (PSID). Lower SES was defined as one of 3 indicators: education ≤12 years, unemployed, or individual annual income <$27,800. Psychological distress was assessed using the Kessler K6 scale. Cox proportional hazard regression was conducted. Mediation analyses were performed using the PROCESS macro.
resultsIn the sample of heads of family who did not have self-reported hypertension in 2009 (N = 6,214), the mean age was 41 years, 30.6% were female, 32.9% were African American. The cumulative incidence of self-reported hypertension was 29.8% between 2009 and 2019. Cox proportional hazard regression analysis showed that after controlling for covariates, lower SES (score > 0 vs. score = 0) was associated with self-reported hypertension (hazard ratio = 1.27, 95% confidence interval = 1.14-1.42). SES had indirect effect on self-reported hypertension through psychological distress and the indirect effect (0.02 in females, 0.01 in males, P < 0.05) was moderated by sex but not by race.
conclusionsThe association of SES and self-reported hypertension was mediated by psychological distress and sex moderated the mediation effect. Interventions focused on reducing contributors to SES and psychological stress should be considered to reduce hypertension risk.
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