Relationships between psychological distress and health behaviors among Canadian adults: Differences based on gender, income, education, immigrant status, and ethnicity

Abstract

Objective Psychosocial health predicts physical health outcomes in both clinical samples and the general population. One mechanism is through relationships with health behaviors. Results might differ based on sociodemographic characteristics such as education, income, ethnicity, and immigrant status. Our objective was to analyze sociodemographic differences in relationships between psychosocial health measures and health behaviors in the general population of Canadian adults. Methods We analyzed relationships between non-specific psychological distress, assessed using the Kessler-10 scale, and five key health behaviors: fruit and vegetable intake, screen sedentary behavior, physical activity, alcohol consumption, and cigarette use. Data were collected by Statistics Canada for the Canadian Community Health Survey in 2011–2014. Our sample included 54,789 participants representative of 14,555,346 Canadian adults. We used univariate general linear models on the weighted sample to analyze relationships between distress (predictor) and each health behavior, controlling for age. We entered sex and one of four sociodemographic variable of interest (education, income, ethnicity, immigrant status) into each model to analyze gender and sociodemographic differences in relationships. Results Greater distress predicted less fruit and vegetable intake and physical activity, and greater screen sedentary behavior and cigarette use, in the full sample, with small effect sizes (partial η 2 up to 0.013). Differences by gender and sociodemographic characteristics were evident for all health behaviors. Conclusions Psychosocial health might contribute to persistent socioeconomic disparities in health in part through relationships with health behaviors, although relationships in the general population are modest. Health behavior interventions incorporating psychosocial health might need to be tailored based on socioeconomic characteristics, and future research on intersections between multiple sociodemographic risk factors remains necessary.

Psychosocial Stress, Sedentary Behavior, and Physical Activity during Pregnancy among Canadian Women: Relationships in a Diverse Cohort and a Nationwide Sample

“…Self-reported participation in leisure-time sedentary behaviors in the CCHS was also consistent with other studies, averaging 3.3 h per day. This is similar to our estimates of screen sedentary behavior among men and women in the general population, which ranged from around 18 to 25 h per week (2.6-3.6 h/day) and varied by gender and sociodemographic characteristics [16]. Among pregnant women, studies in the US that assessed responses to 2 questions on time spent watching TV and sitting quietly performing other activities showed an average of 2.6 h of sedentary behavior per day [26].…”

“…In the general population, greater symptoms of psychological distress, depression, and anxiety predict lower physical activity levels [14,15]. Similarly, our studies among the Canadian general population show that greater psychological distress predicted lower self-reported leisure-time physical activity and greater screen sedentary behavior [16]. Among pregnant women, past studies show that greater pregnancy-specific stress and perceived stress are associated with less exercise [17].…”

“…Similarly, psychological distress predicted decreased likelihood of participating in medium or high levels of leisure physical activity among Australian women in socially disadvantaged neighborhoods [29]. Our studies among Canadian adults showed very weak negative relationships between psychological distress and physical activity, with more marked negative relationships among adults with greater education and income [16]. In general, results of the current study suggest that stress and distress might represent risk factors for less physical activity in early or mid-pregnancy, but not in late pregnancy.…”

“…Studies among Australian women in socioeconomically disadvantaged neighborhoods showed that psychological distress predicted increased television viewing [29], and studies among Puerto Rican adults living in the US showed that those with the highest perceived stress had greater television viewing time [15]. Our own studies among Canadian adults showed positive relationships between psychological distress and sedentary behavior among all adults, with variations by sociodemographic characteristics such as ethnicity, immigration status, and education [16]. However, we identified very few similar studies among pregnant women.…”

Psychosocial Functioning, BMI, and Nutritional Behaviors in Women at Cardiovascular Risk

“…The relationship between psychological distress and negative health behaviors is well-supported. For example, one study found an association between general emotional distress and poorer exercise behaviors, i.e., greater sedentariness and reduced physical activity ( St.-Pierre et al, 2019 ). Psychological distress has also been found to predict greater consumption of palatable, non-nutritious foods (e.g., Groesz et al, 2012 ).…”