Demirer, Ibrahim ORCID: 0000-0001-5346-4739, Bethge, Matthias, Spyra, Karla ORCID: 0000-0002-9134-5834, Karbach, Ute ORCID: 0000-0003-3479-9474 and Pfaff, Holger ORCID: 0000-0001-9154-6575 (2021). Does social support mediate the effect of multimorbidity on mental wellbeing in the German working population? A longitudinal mediation analysis using structural equation modelling. SSM-Popul. Health, 13. OXFORD: ELSEVIER SCI LTD. ISSN 2352-8273

Full text not available from this repository.


This study provides insights into the longitudinal relation between multimorbidity, mental wellbeing, and social support. The analysis used the German Sociomedical Panel of Employees, a study of the German working population aged 40 to 54. In the context of multimorbidity, this population has been little studied. Multimorbidity is significantly associated with reduced mental wellbeing and social support, whereas social support increases mental wellbeing. We argue that, especially among the working population, multimorbidity reduces perceived social support and decreases mental wellbeing. We elaborate on the mediation process empirically by comparing two distinct structural equation models: a cross-lagged panel mediation model that models a potential reverse-causality between social support and mental wellbeing; and a synchronous mediation model that allows for more immediate mediation. Both models estimated significant mediation. The relative size of the mediation effect, however, varied widely based on the added mediational paths (8.57% vs. 28%). Fit statistics for both models were good, and the comparison did not favour either model. We conclude that theoretical reasoning must prevail over empirical testing. The cross-lagged model implies a more longitudinal (lagged) mediation process for social support. However, we suggest an immediate, flexible mediation as more plausible. Nevertheless, we suggest that cross-lagged models, when given a data structure and time gaps, reflect the social processes adequately.

Item Type: Journal Article
CreatorsEmailORCIDORCID Put Code
URN: urn:nbn:de:hbz:38-589906
DOI: 10.1016/j.ssmph.2021.100744
Journal or Publication Title: SSM-Popul. Health
Volume: 13
Date: 2021
Place of Publication: OXFORD
ISSN: 2352-8273
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
Public, Environmental & Occupational HealthMultiple languages


Downloads per month over past year



Actions (login required)

View Item View Item