University of Wisconsin–Madison Medical College of Wisconsin

Social Determinants of Health and Health Outcomes: The Mediating Role of Coping Strategies

Amanda M. Brouwer, PhD; Lindsay Menard, MPH

WMJ. 2020;119(1):56-61.

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Background: Associations between poor health and sociodemographics exist, but the role of coping strategies in this relationship is understudied. Therefore, we examined how adaptive and maladaptive coping affected the relationship between social determinants of health and health outcomes.

Methods: Participants completed survey questions about demographics, health status, and coping strategies. Mediation analyses examined whether education, income, and race affected health status indirectly through coping behaviors.
Results: Maladaptive, but not adaptive, coping strategies, mediated the relationship between income and health and education and health.

Discussion: The use of maladaptive coping strategies plays an intervening role in the relationship between income and health and education and health for some groups. Recommendations for promoting education and policies to reduce the use of maladaptive coping are discussed.

Author Affiliations: Winona State University, Winona, Minn (Brouwer); La Crosse County Human Services Department, La Crosse, Wis; (Menard); Dane County Legislative Management System Office, Madison, Wis (Menard).
Corresponding Author: Amanda M. Brouwer, PhD, Winona State University, 175 W Mark St, Winona, MN 55987, phone 507.457.5477; email
Financial disclosures: None declared.
Funding Support: None declared.
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