Socioeconomic health disparities revisited: coping flexibility enhances health-related quality of life for individuals low in socioeconomic status

Background: Previous research has generally indicated that disadvantaged socioeconomic groups tend to experience poor health-related quality of life (HRQoL). In an effort to extend the literature, this study proposes that coping flexibility is a stress buffer that mitigates the adverse effects of low socioeconomic status (SES). Methods: The participants comprised 150 Indians (53 % women; mean age = 36.38 years) from high, medium and low socioeconomic groups. Their levels of perceived stress, coping flexibility, subjective SES and HRQoL were assessed individually through household interviews. Results: The findings provide support for the hypothesised moderating role of coping flexibility between subjective SES and HRQoL (p < 0.001). In the low SES group, participants higher in coping flexibility reported significantly better HRQoL than those lower in coping flexibility. Moreover, coping flexibility moderated the association between perceived stress and HRQoL (p = 0.001). Of the participants who experienced higher levels of stress, those higher in coping flexibility reported better HRQoL than those lower in coping flexibility. Conclusions: This study enriches the literature by revealing the beneficial role of coping flexibility on HRQoL among individuals low in SES. These new findings highlight the potential importance of psychological interventions that strengthen the flexible coping skills of socioeconomically disadvantaged groups.