Family-related Social Adversities and Self-Rated Health among Families in the Northwest of Iran: A Multi-Mediation Path Analysis

Introduction: Self-rated health (SRH) is a crucial indicator of overall health status, influenced by various social factors, including family structure and characteristics. This study aimed to examine both the direct and indirect associations of family adversities on individuals' SRH. Methods This cross-sectional descriptive-analytical study was conducted on 1,220 adults. Participants were selected using a multistage cluster sampling method from the health centers in Qazvin city, in the northwest of Iran. Data were collected through an online platform, utilizing checklists for demographics, SRH, and family adversities. Path analysis was employed to assess the direct and indirect relationships between family adversities and SRH. Results Only 42.2% of participants reported optimal SRH. The most prevalent family adversities were internet addiction (41.7%), the presence of a smoker (29%), and unemployment within the family (20.5%). Indirect associations on self-rated health (SRH) via the combined moderating roles of conflicts/arguments and abuse were significantly negative for each predictor: internet addiction (β = -0.04, p < 0.001), unemployment (β = -0.03, p < 0.001), drug & alcohol use (β = -0.07, p < 0.001), and prisoner & robber status (β = -0.03, p = 0.011). Conclusion The prevalence of sub-optimal SRH among the study population was alarmingly high. The findings suggest that family problems can impact SRH through increased conflicts and abuse within the household. Therefore, interventions targeting these mediating factors may contribute to improving the SRH of family members.