Health behaviors at the start of the COVID-19 pandemic: Evidence for indirect effects of subjective social status via psychological distress.

This study examined the role of psychological distress in linking socioeconomic status (SES) and subjective social status (SSS)—one's perceived social standing—to health behaviors during the early months of the COVID-19 pandemic among 412 U.S. adults. Findings indicated that lower SSS, but not SES, was indirectly associated with poorer current sleep quality, perceived worsening of sleep, and decreased physical activity through greater psychological distress. In contrast, SES showed direct associations with higher alcohol consumption and perceived decreased sleep quality but was not linked to distress. The results suggest that SSS and SES represent distinct constructs with independent relationships to psychological distress and health behaviors, supporting the reserve capacity model's emphasis on psychosocial resources. These findings highlight the importance of addressing psychological distress to mitigate adverse health behavior changes during global stressors, particularly among individuals with lower perceived social status.