Stressors and resources mediate the association of socioeconomic position with health behaviours

Questionnaire data on sociodemographic variables, stressors, resources, and health behaviours were collected cross-sectionally among inhabitants (n = 3050) of a medium-sized Dutch city (Utrecht). Descriptive statistics and bootstrap analyses for multiple-mediator effects were used to examine the role of stressors and resources in mediating educational associations with health behaviours.Higher levels of stressors and lower levels of resources could be represented by a single underlying factor, and co-occurred among those with lower educational levels. Stressors and resources partially mediated the relationship between education and four health- behaviours (exercise, breakfast frequency, vegetable consumption and smoking). Financial stress and poor perceived health status were mediating stressors, and social support a strong mediating resource. An aggregate measure of the stressors and resources showed similar associations with health behaviours compared to the summed individual measures.Lower educated groups are simultaneously affected by the presence of various stressors and absence of multiple resources, which partially explain socioeconomic differences in health behaviours. Compared to the direct associations of stressors and resources with health behaviours, the association with socioeconomic status was modest. Therefore, besides addressing structural inequalities, interventions promoting financial management, coping with chronic disease, and social skills training have the potential to benefit large parts of the population, most notably the lower educated. Further research is needed to clarify how stressors and resources impact health behaviours, why this differs between behaviours and how these disparities could be alleviated.Indicators of socioeconomic position, such as education, occupation, income and wealth, are negatively related to morbidity and mortality [1-8]. In order to intervene in these disparities, it is important to understand how lower socioecon