Türkiye’de Algılanan Sağlık ve Duygusal İyi Oluşla İlişkili Etkenler: Sosyal Destek ve Finansal Zorlanmanın Rolü

Abstract

Sağlığın belirleyicileri olan psikososyal ve maddi kaynakların ulusal düzeydeki rolleri nadiren birlikte incelenmektedir. Bu çalışmada, Türkiye Genel Sosyal Araştırması 2024 (TGSS-2024) verileriyle 2.615 yetişkinde algılanan sağlık ve duygusal iyi oluş (Cronbach’s α=0,88) ile ilişkili etkenler incelenmiştir. Sosyal destek (α=0,71) ve finansal zorlanmaya odaklanılarak demografik, sosyoekonomik ve yaşam tarzı değişkenleri modele dâhil edilmiştir. İlişkiler, verideki düzensizliklere karşı sonuçları koruyan dirençli (robust) standart hatalarla hiyerarşik regresyon kullanılarak incelenmiş; sosyal desteğin krizin etkilerini hafifletici koruyucu bir mekanizma olduğunu savunan stres-tampon hipotezi test edilmiştir. Bulgulara göre sosyal destek, her iki çıktıyla (iyi oluş: β=0,40; sağlık: β=0,25) en güçlü ilişkiye sahip faktördür. Finansal zorlanma ise algılanan sağlık (β=−0,15) ve iyi oluşla (β=−0,13) bağımsız ve olumsuz ilişkilidir. Sosyal destek, finansal zorlanma-iyi oluş ilişkisini anlamlı düzeyde hafifletmiş (etkileşim β=+0,07, p=0,002); yüksek sosyal destekte stresin etkisi yaklaşık üç kat zayıflamıştır. Ancak bu düzenleyici etki sınırlı düzeydedir (ΔR²=%0,6) ve algılanan sağlık üzerinde bulunmamıştır. Kesitsel nitelikteki bu bulgular, sosyal desteğin toplum sağlığıyla en güçlü ilişkiye sahip kaynak olduğuna işaret etmekte ve ekonomik zorluklara yönelik müdahalelerde psikososyal destek sistemlerinin de dikkate alınabileceğini düşündürmektedir.

Keywords

• Sosyal destek
• finansal zorlanma
• algılanan sağlık
• duygusal iyi oluş

Supporting Institution

Bu araştırma, kamu, ticari veya kâr amacı gütmeyen sektörlerdeki herhangi bir finansman kuruluşundan özel bir destek almamıştır.

Ethical Statement

Bu çalışma, kamuya açık ve tümüyle anonimleştirilmiş Türkiye Genel Toplumsal Araştırması 2024 (TGSS-2024) veri setinin ikincil analizine dayanmaktadır; kapsamında insan katılımcılarla yeni bir etkileşim kurulmamış ve kimlik belirleyici hiçbir bilgiye erişilmemiştir. Helsinki Bildirgesi ilkeleri uyarınca, kamuya açık ve anonim verilerin ikincil analizine dayanan, yeni veri toplanmayan bu tür çalışmalar etik kurul onayından muaftır; bu nedenle ayrıca etik kurul onayı alınmamıştır. Verilerin asıl toplanmasındaki gerekli izinler ve katılımcı onamları Türkiye İstatistik Kurumu tarafından alınmıştır.

Factors Associated with Self-Rated Health and Affective Well-Being in Türkiye: The Roles of Social Support and Financial Strain

Abstract

Health reflects not only material circumstances but also psychosocial resources, yet their relative roles are rarely examined together in national data. Using the Turkish General Social Survey 2024 (TGSS-2024), a national survey of 2,615 adults, we examined the factors associated with two separate outcomes, self-rated health and affective well-being (a ten-item affect battery indexing predominantly low psychological distress; Cronbach’s α=0.88), focusing on social support (α=0.71) and financial strain, with healthy lifestyle behaviours and demographic and socioeconomic covariates, and religiosity examined descriptively. Associations were estimated with hierarchical linear regression using heteroscedasticity-consistent (HC3) robust standard errors, and the stress-buffering hypothesis was tested as a social support × financial strain interaction; robustness checks included post-stratification weighting, regional fixed effects, region-clustered standard errors, and a marker-variable common-method check. Social support was the factor most strongly associated with both outcomes, and more so with affective well-being (β=0.40) than self-rated health (β=0.25). Financial strain was independently associated with worse self-rated health (β=−0.15) and lower well-being (β=−0.13). Social support significantly moderated the financial strain–well-being association (interaction β=+0.07, p=0.002), which was about three times weaker at high than at low support (β=−0.07, p=0.03 versus β=−0.21, p<0.001) attenuated but not eliminated, and modest in size (ΔR²=0.6%); no moderation was found for self-rated health. Men reported higher scores on both outcomes, and the dimensions diverged across age. These cross-sectional findings identify social support as the resource most strongly associated with population health, warranting attention in responses to economic strain.

Keywords

• Social support
• financial stress
• self-rated health
• affective well-being

Supporting Institution

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Ethical Statement

This study is a secondary analysis of the publicly available and fully anonymised Turkish General Social Survey 2024 (TGSS-2024) dataset; it involved no new interaction with human participants and no access to identifying information. In accordance with the principles of the Declaration of Helsinki, secondary analyses of publicly available, anonymised data that do not involve the collection of new data are exempt from ethics-committee approval; accordingly, no separate ethics-committee approval was sought. The necessary permissions and participant consent for the original data collection were obtained by the Turkish Statistical Institute.

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