Developing a Social Health Model Based on Social Support and Social Trust in Female-Headed Households

Understanding the multifactorial nature of health has shifted the traditional narrow focus on women's reproductive health to an acknowledgment of the influence of socioeconomic and cultural characteristics on their health status. The changing roles of women have also affected their health status. Social support refers to the emotionally sustaining qualities of relationships. In addition to social support, social trust is considered a key element of social capital and has received great attention, particularly in the area of public health. Family life is associated with multiple tensions and pressures for female–headed households. Thus, these women encounter numerous psycho–socio–economic problems that adversely impact their health. Women play a major role in family and community health; thus, it is essential to examine women's health in the community. Accordingly, this study aimed to develop a social health model based on social support and social trust in female–headed households.

The present correlational study employed a structural equation modeling. The statistical population of the study included all female–headed households in Rasht City, Iran, in 2019. Based on the ratio of the number of participants to the observed variables, the sample size was estimated as 380 individuals. To select the research sample, the city of Rasht was clustered based on different areas of the municipality. After randomly selecting 4 of the 5 districts, 2 neighborhood houses were randomly selected. Finally, considering the odds of sample dropout, 380 eligible individuals entered the study. Accordingly, after sample dropout, their number reached 358. The inclusion criteria of the research included female–headed households, no chronic physical illnesses, and substance dependence, and not receiving pharmacotherapy for chronic and specific physical or mental illnesses in the past 6 months. The exclusion criteria of the study were the violations of any of the inclusion criteria; all of which were assessed using a researcher–made demographic questionnaire answered on a yes/no scale. The Social Wellbeing Questionnaire–Short Form (Keyes, 1998), Family Social Support Questionnaire (Khodapanahi et al., 2009), and Social Trust Questionnaire (Saffarinia & Sharif, 2014) were used for data collection. Descriptive statistics, including mean and standard deviation, were used to analyze the obtained data. Structural equation modeling and Pearson correlation coefficient were also applied in AMOS and SPSS to analyze the collected data. The significance level of the tests was considered 0.05.

The path coefficient between social support and social trust (β=0.351, p=0.001), the path coefficient between social trust and social health (β=0.324, p=0.001), and the coefficient of the direct path between social support and social health (β=0.460, p=0.001) were positive and significant. Additionally, the total path coefficient between social support and social health was positive and significant (β=0.574, p=0.001). Finally, the indirect path coefficient between social support and social health with the mediating role of social trust was positive and significant (β=0.114, p=0.012). The present study results suggested that the hypothesized model had fitness with the collected data (χ2/df=3.31, CFI=0.934, GFI=0.912, AGFI=0.875, RMSEA=0.081).

According to the obtained findings, social trust mediates the relationship between social support and social health among female–headed households. Therefore, the role of social support and social trust in the health of women heads of households should be considered.