Social support, health literacy and depressive symptoms among medical students: an analysis of mediating effects

Yaqin Zhong, Elizabeth Schroeder, Yuexia Gao, Xiaojun Guo, Yuanyuan Gu*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

15 Citations (Scopus)
17 Downloads (Pure)


Depressive symptoms are prevalent in university students and may impair their social, educational, and economic transition into adulthood. Identifying the factors that determine depressive symptoms is crucial for the design of effective policy interventions. This study aims to examine the associations between health literacy and depressive symptoms among medical students, and to evaluate the effect of different types of social support as a potential mediator. A cross-sectional survey of medical students was conducted through convenience sampling in East China. Associations between variables were explored using OLS and the mediation effect was estimated using the Karlson, Holm and Breen method. A total of 746 valid questionnaires were collected. The prevalence of depressive symptoms among the sample was 32.4%. Higher health literacy levels and social supports were significantly associated with lower levels of depressive symptoms. Social support partially mediated the association between health literacy and depressive symptoms, accounting for a 54.03% of the total effect size. These findings suggest that interventions for medical student mental wellbeing could improve health literacy. Whilst family support reflects greatest impact, Universities can also lead and innovate novel interventions for this critical stage of life. Future research can extend this study by exploring the dynamic interactions between health literacy, depressive symptoms, and other sources of social support. Comparisons of these findings across the different regions of China and in other university subject disciplines are also warranted.
Original languageEnglish
Article number633
Pages (from-to)1-12
Number of pages12
JournalInternational Journal of Environmental Research and Public Health
Issue number2
Publication statusPublished - 13 Jan 2021

Bibliographical note

Copyright © 2021 by the authors. Licensee MDPI, Basel, Switzerland. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.


  • health literacy
  • social support
  • depressive symptoms
  • mediation effects
  • medical students


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