The role of social activity in the association between socioeconomic status and physical health in Tehran University of Medical Sciences employees` cohort study: a structural equation modeling

ABSTRACT

Socioeconomic status (SES) is often considered a major predictor of health outcomes. This study aimed to determine the role of social activity in the association between SES and physical health among Tehran University of Medical Sciences Employees’ Cohort (TEC) study. In this cross-sectional design, we used the data of the enrolment phase of the Tehran University of Medical Sciences (TUMS) cohort study on 4461 employees. The latent variable of this study was the composite SES-index, which is a combination of assets, social activities, and education. A self-reporting questionnaire was used to measure the physical health conditions of the respondents. The relationship between variables was examined using the structural equation modeling (SEM) in STATA-14. The results showed that 2706 respondents (60.65%) were female and the mean age of all participants was 42.29 years (SD = 8.71, range: 19 to 74). The SEM results showed that the composite SES-index had a significant effect on physical health (β = −0.21, SE = 0.017, p < 0.001, 95٪ CI = [−0.25 to −0.18]). Physical health also exhibited the greatest association with the social activity index (β = −0.18, SE = 0.014, p < 0.001, 95٪ CI = [−0.21 to −0.15]). In addition, the social activities, assets, and education explained 53%, 50%, and 43% of the estimated variance of the composite SES-index, respectively. This study demonstrated that the social activity index could be one of the best proxy indicators of objective SES when we intend to assess the association between SES and physical health.

KEYWORDS:

• Socioeconomic status
• physical health
• social activity
• TUMS Employee’s Cohort study

List of abbreviations

TUMS: Tehran University of Medical Sciences; SES: Socioeconomic Status; STATA: software for data science and statistical analysis; DW: Disability weights; SEM: structural equation modeling; ML: maximum likelihood; TEC study: Tehran University of Medical Sciences employees` cohort; CATPCA: Categorical Principal Components Analysis; RMSEA: Root Mean Square Error of Approximation; SRMR: Standardized Root Mean Square Residuals; CFI: comparative fit index; TLI: Tucker–Lewis index; SD: standard deviation.

Acknowledgments

This study was part of a Ph.D. thesis supported by the Tehran University of Medical Sciences (TUMS), and it has been done by the cooperation of TUMS Employees’ Cohort (TEC) study; (Grant no: 36600). The authors are grateful to patients, who participated in the study, for their time participating in the study.

Data Availability Statement

The datasets of participants used and analyzed during the current study were acquired from the enrolment phase of the Tehran University of Medical Sciences employees` cohort (TEC) study. However, the datasets collected during the current study are available from the corresponding author on reasonable request.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Authors’ contributions

F.M drafted the manuscript, contributed to the conception, and performed the analytic calculations and interpretation of data. A.RF designed the statistical model, the computational framework. MA.V analyzed the data, the computational framework. S.N conceived of the presented idea, collected data management, designed the study, and critically revised the analysis and manuscript. All authors read and approved the final manuscript.

Ethical consideration

Ethical approval for this study was obtained from the Ethics and Research Committee of Tehran University of Medical Sciences (TUMS.VCR.REC.1398.829). Before registration, all participants read and sign the informed written consent form. A copy of the signed consent form is given to the participant. The guidelines on research involving the use of human subjects (beneficence, non-maleficence, veracity, confidentiality, and voluntarism) were strictly adhered to according to the Helsinki Declaration. Participants did not incur any cost by participating in this study and there was no financial inducement.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14635240.2022.2106288

Additional information

Funding

This work was supported by the deputy of research and technology of the ministry of health and the medical education of the Islamic Republic of Iran under Grant number 36600.