The mediating roles of physical exercise and social-psychological stress in the relationship between socioeconomic status and self-rated health.

Low socioeconomic status was associated with poorer self-rated health.

• The standardized coefficient for the direct effect of SES on SRH was β = 0.23.
• The study included 1,507 participants aged ≥ 16 years from a Health Survey conducted in Hubei Province during the post-pandemic period of 2021.
• The average SES score was 3.07 ± 1.12 and the average SRH score was 2.93 ± 0.93.
• Significant pairwise correlations (p < 0.05) were found among SES, PE, SPS, and SRH.

Insufficient physical exercise was associated with poorer self-rated health.

• The standardized coefficient for the effect of physical exercise on SRH was β = 0.11.
• Physical exercise was specified as a mediator in the structural equation model examining the association between SES and SRH.
• Physical exercise accounted for 6.7% of the total impact of SES on SRH.

Higher social-psychological stress was associated with poorer self-rated health.

• The standardized coefficient for the effect of social-psychological stress on SRH was β = -0.17.
• Social-psychological stress accounted for 14.2% of the total impact of SES on SRH.
• Social-psychological stress was specified as a mediator in the structural equation model alongside physical exercise.

Both physical exercise and social-psychological stress demonstrated significant partial mediating effects in the relationship between SES and self-rated health.

• Physical exercise mediated 6.7% of the total impact of SES on SRH.
• Social-psychological stress mediated 14.2% of the total impact of SES on SRH.
• Structural equation modeling (SEM) was used to examine the mediating and interaction effects.
• The mediation was partial, as SES retained a direct significant effect on SRH (β = 0.23).

The interaction between physical exercise and social-psychological stress was statistically significant only among females.

• The interaction between PE and SPS was statistically significant only among females (p < 0.05).
• No statistically significant interaction between PE and SPS was observed among males.
• This sex-specific interaction effect was examined within the structural equation modeling framework.