Background and objective:
Self-ratings about personal health are broad self-evaluations of health status which reflect general dimensions of health including chronic conditions. The construct of Self-rated health is related to multiple domains of health outcomes such as mortality rates, comorbidities, psychological distress and the numerous psychosocial effects that result from socio-economic inequalities in health. The primary focus of our study is to apply a theoretical framework drawing on the stress process paradigm to examine the central research question: Do religiosity dimensions and social trust mediate and/or moderate against the deleterious effects of one ecological chronic stressor: neighborhood disadvantages?

Methods:
This study applies nested models using stereotype logistic regression to analyze a random probability sample (n=3531) from the World Values Survey (WVS) in South Africa. Self-rated health was measured in a single survey question: All in all, how would you describe your state of health these days? In response, study participants were asked to indicate where they would put themselves on an ordinal scale (i.e., Very Good; Good; Fair; Poor).

Results:
(1) Neighborhood disadvantages predicted lower self-ratings of health (p < 0.00), controlling for respondents’ demographic characteristics, income, employment, religious affiliation and exposure to violence in the past year; (2) the effects of social trust were only limited to mediate against ecological stress; however (3) higher religious engagement predicted more favorable ratings on health status, thus diminishing the negative effects of the stressor.

Conclusion:
This study contributes to the literature by investigating the interface between self-rated health and ecological chronic stress in sub-Saharan Africa. Our empirical results lend credence to the positive effects of social involvement to mitigate the deleterious effects of neighborhood disadvantages.