Objective:Chronic noncommunicable conditions are a major driver of poor health in low-and middle-income countries,yet the mental health pathways through which these illnesses shape perceived health remain underexamine...Objective:Chronic noncommunicable conditions are a major driver of poor health in low-and middle-income countries,yet the mental health pathways through which these illnesses shape perceived health remain underexamined.This study investigates whether recent mental well-being—measured using the World Health Organization Five-Item Well-Being Index(WHO-5)—mediates the association between chronic illness and self-rated health(SRH)among Egyptian adults aged 32–65.Methods:This study uses nationally representative data from the 2023 Egypt Labor Market Panel Survey(n=23,044)and estimates survey-weighted Ordinary Least Squares models predicting SRH(1=very good/excellent to 5=very bad).The key independent variable is chronic illness status.Mediation analysis is conducted using the Sobel–Goodman method with 1000 bootstrap replicates.All models adjust for sociodemographic covariates including age,sex,education,marital status,and regional residence.Results:Chronic illness is associated with significantly worse SRH(β=0.59,standard error[SE]=0.02,P<0.001).When mental well-being is added to the model,the chronic illness coefficient declines to 0.50(SE=0.02,P<0.001),and WHO-5 is independently associated with better SRH(β=-0.22,SE=0.01,P<0.001).The indirect effect via WHO-5 is 0.08(SE=0.01,P<0.001),indicating that 14.2%of the total association is mediated through recent psychological well-being.Conclusion:Although most of the self-rated health disadvantage linked to chronic illness flows through somatic and functional channels,mental well-being accounts for a meaningful share.Incorporating WHO-5 screening and stepped referral into chronic care could improve subjective health outcomes in Egypt.Mental health integration should be viewed as a critical component of equitable noncommunicable disease strategies.展开更多
文摘Objective:Chronic noncommunicable conditions are a major driver of poor health in low-and middle-income countries,yet the mental health pathways through which these illnesses shape perceived health remain underexamined.This study investigates whether recent mental well-being—measured using the World Health Organization Five-Item Well-Being Index(WHO-5)—mediates the association between chronic illness and self-rated health(SRH)among Egyptian adults aged 32–65.Methods:This study uses nationally representative data from the 2023 Egypt Labor Market Panel Survey(n=23,044)and estimates survey-weighted Ordinary Least Squares models predicting SRH(1=very good/excellent to 5=very bad).The key independent variable is chronic illness status.Mediation analysis is conducted using the Sobel–Goodman method with 1000 bootstrap replicates.All models adjust for sociodemographic covariates including age,sex,education,marital status,and regional residence.Results:Chronic illness is associated with significantly worse SRH(β=0.59,standard error[SE]=0.02,P<0.001).When mental well-being is added to the model,the chronic illness coefficient declines to 0.50(SE=0.02,P<0.001),and WHO-5 is independently associated with better SRH(β=-0.22,SE=0.01,P<0.001).The indirect effect via WHO-5 is 0.08(SE=0.01,P<0.001),indicating that 14.2%of the total association is mediated through recent psychological well-being.Conclusion:Although most of the self-rated health disadvantage linked to chronic illness flows through somatic and functional channels,mental well-being accounts for a meaningful share.Incorporating WHO-5 screening and stepped referral into chronic care could improve subjective health outcomes in Egypt.Mental health integration should be viewed as a critical component of equitable noncommunicable disease strategies.
