Skip to main content
Download PDF

Determinants of life satisfaction and self-rated health in Iranian children and adolescents: a structure equation model

BMC Pediatrics volume 22, Article number: 4 (2022) Cite this article

Abstract

Background

Life satisfaction (LS) and self-rated health (SRH) are related with health outcomes. It is expected that these items are also related to healthy behaviors. Therefore, this study was conducted in order to find out the main determinants of LS and SRH in nationwide representative sample of Iranian children and adolescents.

Methods

This study was performed on 13,834 students aged 7–18 years who were selected by multistage, stratified cluster sampling method from 30 provinces of Iran. Life satisfaction and SRH were assessed through a questionnaire based on World Health Organization-Global School-based Student Health Survey protocols. Path analysis was applied to evaluate the relationships among the study variables using the structural modeling.

Results

Life satisfaction was directly affected by age (− 0.037 in boys & -0.028 in girls); sedentary time (0.055 in boys & 0.048 in girls); school satisfaction (0.249 in boys & 0.250 in girls); and well-being (0.186 in boys & 0.176 in girls). Self-rated health was directly affected by LS (0.28 in boys & girls) and school satisfaction (0.21 in boys & 0.22 in girls); and indirectly affected by age (− 0.046 in boys & -0.017 in girls); sedentary time (− 1.99 in boys & -0.145 in girls); family size (− 0.005 in boys & -0.014 in girls); and socio-economic status (0.015 in boys & 0.058 in girls).

Conclusions

This study indicated that school satisfaction had the greatest positive direct effect on both LS and SRH.

Peer Review reports

Introduction

Childhood and adolescence are considered to be a life phase in which future health patterns for adulthood are being initiated. It is characterized as a period of relatively good physical and mental health, high life satisfaction, and low mortality. During this developmental outlook, low life satisfaction and bad health condition can have a diverse effect on the improvement of developmental challenges related to adolescence and ultimately lead to several long-term negative consequences in adulthood [1, 2]. Infectious disease, malnutrition, and mortality have been lowered in children and adolescent populations, however, shifting attention to chronic diseases, mental health problems, obesity, and physical illness, which their prominence during childhood and adolescence is very concerning [3]. Life satisfaction (LS) and self-rated health (SRH), assess different dimensions of individuals’ own health that show some non-biomedical factors of general well-being framed by individual, familial and social dimensions [4]. Life satisfaction can be defined as the degree to which an individual judges the overall quality of his life-as-a-whole favorably [5]. Self-rated health is considered a powerful global indicator of health and mortality that show the effects of some non-biomedical factors, such as lifestyle, psychosocial, and socio-demographic conditions [6]. An increasing body of literature has been conducted regarding the relationship between LS and factors related to social conditions such as the individual’s living conditions or society-level, economic well-being, and physical and mental health on adult populations [7,8,9]. However, there is limited practical investigation on SRH and LS for children or adolescents. Therefore, the present study aimed to comprehend main determinants of LS and SRH in a nationwide representative sample of Iranian children and adolescents according to the path analysis, as a powerful statistical model in evaluating a complex cluster of dependent variables [10].

Methods

Procedures and participants

This nationwide study was conducted in urban and rural areas of Iran in 2015 as the fifth national survey of a school-based surveillance program entitled the Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable disease (CASPIAN-V) study. Data was checked at the district level by academic supervisors (expert of school health) and controlled by national supervisors and operators. Detailed description of the sampling and data collection methods are published previously [11].

The study population consisted of students aged 7–18 years in primary and secondary schools in urban and rural areas across the country. Totally, 13,834 students were selected by multistage, stratified cluster sampling method from 30 provinces of the country (48 clusters of 10 students in each province). Stratification was performed in each province according to the residence area (urban/rural) and level of education (primary/ secondary). The sampling size was proportional to population in each urban or rural area with equal sex ratio. Cluster sampling with equal clusters was used in each province to reach the necessary sample size. Clusters were determined at the level of schools, including 10 statistical units (students and their parents) in each cluster.

The protocols of the present study were assessed and approved by the Research and Ethics Council of Isfahan University of Medical Sciences (Project Number: 194049). Written informed consent and verbal consent was obtained from the parents and students, respectively [11]. This study was conducted according to the guidelines laid down in the Declaration of Helsinki, and all procedures involving human subjects were approved by Ethics Committee of Isfahan University of Medical Sciences.

Anthropometric measurements

Trained healthcare staff conducted the anthropometric measurement according to the standard protocol [12]. Height was measured without shoes to the nearest 0.5 cm using stadiometer (Seca, Hamburg, Germany). Weight was measured with light clothes to the nearest 0.1 kg by scale (Seca, Hamburg, Germany). Body mass index (BMI) was calculated as weight (kg) divided by square of height (m2). Waist circumference (WC) was measured at the point midway between the lower border of the rib cage and the iliac crest to the nearest 0.1 cm [11]. Waist to height ration was calculated by dividing WC to height.

Questionnaires

Two sets of the questionnaires were used for students and their parents. The questionnaires were obtained from Global School Student Health Survey (GSHS) that translated to Persian [13]. The reliability and validity of the Persian version of questionnaires was approved in the previous studies [14, 15].

The student questionnaire included questions regarding body image, psychosocial environment of school, dietary habits, life-style habits, and violence behavior. Trained personnel completed questionnaires in a calm atmosphere inside the schools; the whole process was supervised and controlled by a team of health care professionals.

Issues such as family composition, economic and socio-demographic factors, genetic determinants (family history of hypertension, diabetes, and obesity), post-birth data (birth weight, breastfeeding, and type of complementary food), and family dietary habits were included in the parent’s questionnaire which was completed by the parents themselves (Figs. 1 and 2).

Fig. 1
figure 1

Path analysis diagram of association of general characteristics with life satisfaction and self-rated health for boys

Full size image
Fig. 2
figure 2

Path analysis diagram of association of general characteristics with life satisfaction and self-rated health for girls

Full size image

Measuring tools

The questionnaire of the World Health Organization-Global School-based Student Health Survey (WHO-GSHS) was used to assess aggressive behaviors, LS, SRH and counseling with family members. Demographic information on age, gender, residence area, family-based characteristics, living with parents, parental level of education, possessing a family private car and type of home gathered through interview with students. We prepared Persian versions of standardized questionnaires, which were designed based on world health organization models. The validity and reliability of the questionnaires were confirmed through the previous study [16].

Life satisfaction (LS) was assessed through a single item. Students were asked to indicate their degree of life satisfaction by using a tenth-point scale from 1 = very dissatisfied to 10 = very satisfied. Fewer than 6 responses were aligned to dissatisfaction and responses of equal and upper 6 were defined as satisfaction.

Self-rated health (SRH) was assessed through a single item, “how would you describe your general state of health?”; the categories of response were “perfect”, “good”, “bad,” and “very bad”. For statistical analysis, “perfect and good” responses were considered as “good SRH”. Moreover, the preference of participant in consulting with father, mother, and sister/brother and friends were asked for further analyses.

Physical activity was assessed through a validated questionnaire including weekly frequency of leisure time physical activity outside the school during the past week, and having sufficient physical activity was defined as at least 30 min of exercise per day that led to sweating and large increases in breathing or heart rate [13, 17].

Sedentary time Sedentary behavior is considered as the waking time in a sitting, reclining, or lying posture on screen time (television, video game playing, computer using) or reading, characterized by an energy expenditure less than 1.5 metabolic equivalents [18]. The sedentary time was accessed using a validated questionnaire [13, 17].

Socioeconomic status (SES) was calculated through a validated questionnaire [16] included questions about the following socioeconomic indicators: (a) parental level of education (illiterate: score 1, less than high school: score 2, high school graduate: score 3, academic education: score 4); (b) parental occupational status (unemployed: score 1, worker/farmer: score 2, governmental employee: score 3, self-employed: score 4); (c) number of inhabitants in home, and (d) possessing a family private car (yes/no). It should be noted that for questions (a) and (b) (i.e. parental occupational status and level of education) data from the parent or legal guardian with a higher occupational status/education was considered.

School satisfaction was assessed through a validated questionnaire regarding the overall satisfaction with school life experience including interest in learning tasks, attitude to homework, school environment, relationships with teachers and classmates [16].

Social contact was assessed through a validated questionnaire regarding social relationship, the number of friends and time spend with them [16].

Well-being was considered as the overall satisfaction with relationships with family members and friends and current life conditions.

Statistical analysis

All variables were checked for normality and expressed as means (standard deviation, SD). Student’s two-tailed t test was used to compare the mean differences of characteristics between boys and girls. Pearson correlation was applied to examine the relationships between the study variables and to implement the subsequent structural modeling. Path analysis was applied to examine the causal framework. Path analysis includes causal modeling, analysis of covariance structures, and latent variable models. We conceptualized this model according to literature review and our previous studies using causal association in the form of a directed acyclic graph between the explanatory variables with outcomes (LS-SRH). This model is a generalization of multivariate multiple regression that allows one to estimate the strength and sign of direction and indirection association for complicated causal schemes with multiple dependent and independent variables [19, 20]. Path standardized coefficients (β) as the effect sizes of associations were calculated. Goodness of fit (GOF) indices (e.g. The Root Mean Square Error of Approximation (RMSEA), the goodness of fit index (GFI), the adjusted GFI) were applied for assessing of fitness of the model [21]. All of the statistical analysis was performed using IBM, AMOS and STATA 11.0 (STATA Corp, College Station, TX). P-value less than 0.05 was considered as statistically significant.

Results

Totally, 13,834 students (50.7% boys and 49.3% girls; mean age: 12.2 ± 3.15 years) were assessed in this study. There were no significant differences in age, SES, anthropometric indices, ST, school satisfaction, sleep duration, wellbeing, SRH and LS between boys and girls. However, physical activity and social contact were significantly higher in boys than in girls (P < 0.001). Table 1 shows the correlation among variables according to sex. In both sexes, SRH was positively correlated with age (r = 0.029 for boys and r = 0.63 for girls), school satisfaction (r = 0.312 for boys and r = 0.326 for girls), and social contact (r = 0.034 for boys and r = 0.044 for girls), but negatively correlated with LS (r = − 0.367 for boys and r = − 0.370 for girls), physical activity (r = − 0.057 for boys and r = − 0.070 for girls), sedentary time (r = − 0.034 for boys and r = − 0.035 for girls), and sleep duration (r = − 0.097 for boys and r = − 0.123 for girls). In both sexes, LS was positively correlated with SES, sleep duration, social contact, and wellbeing, but negatively correlated with age, ZBMI and school satisfaction (the amounts of “r” are illustrated in the Table 2). In both genders the most correlation was observed between SRH and LS (r = − 0.367 for boys and r = − 0.370 for girls). The direct effect of all variables according to sex is presented in Table 2. In both genders, age showed a positive direct effect on school satisfaction and ZBMI; physical activity had positive direct effect on well-being, social contact and SRH; sedentary time showed positive direct effect on LS and social contact but negative direct effect on physical activity and school satisfaction; school satisfaction and well-being had positive direct effects on both LS and SRH; social contacts had positive direct effect on SRH; life satisfaction had positive direct effect on SRH. In boys, SES had positive direct effect on physical activity, ZBMI, sedentary time and waist to high ratio and negative effect on social contact while social contacts had positive direct effect on school satisfaction. These findings were insignificant in girls.

Table 1 Matrix for Pearson correlation among characteristics
Full size table
Table 2 Direct effects of variables in Iranian children and adolescents
Full size table

The direct, indirect and total effect of variables on LS and SRH is illustrated in Table 3. LS was directly affected by age (− 0.037 in boys & -0.028 in girls), sedentary time (0.055 in boys & 0.048 in girls), school satisfaction (0.249 in boys & 0.250 in girls), and well-being (0.186 in boys & 0.176 in girls). The other variables including sleep duration, physical activity, family size, SES, and social contact had slight indirect effect on LS. Among studied variables, only age and sedentary time had both direct and indirect effect on LS. In both genders, school satisfaction had the greatest direct effect and social contact had the greatest indirect effect on LS.

Table 3 Total effects of variables on life satisfaction and self-rated health in Iranian children and adolescents
Full size table

In case of SRH, school satisfaction, well-being, sleep duration, and physical activity had both direct and indirect effect on SRH in both genders. Self-rated health was directly affected by LS (0.288 in boys & 0.287 in girls); and indirectly affected by age (− 0.046 in boys & -0.017 in girls), sedentary time (− 1.99 in boys & -0.145 in girls), family size (− 0.005 in boys & -0.014 in girls), and SES (0.015 in boys & 0.058 in girls). In both genders, LS had the greatest direct effect on SRH. After that, school satisfaction had the greatest direct effect on SRH in boys and well-being had the greatest direct effect on SRH in girls (Supplementary Figures).

The results of model fitness with accepted range for evaluating the validity of the model are characterized in Table 4. There are a variety of fit indices to evaluate the model. All of them demonstrated that the model had acceptable fitting.

Table 4 The results of model fitness
Full size table

Discussion

This study was designed to evaluate the important determinants of LS and SRH in nationwide representative sample of Iranian children and adolescents examining the direct and indirect effects of different physical and psychosocial status of children on their LS and SRH.

In this investigation, LS and SRH showed a strong correlation with each other. Life satisfaction is an assessment of overall well-being and SRH indicates the children and adolescents’ perception of their health and applies as an index for their physiological conditions [3, 22]. The relationship of LS and SRH was reported in previous researches [23,24,25]. Studies showed that individuals with a healthy lifestyle have better SRH and higher LS [26]. The evaluation of LS and SRH from a holistic approach is very complex and so many factors influence them. In this study, we tried to determine the most effective factors in LS and SRH in children and adolescents. Through the path analytic method we found that among studied variables, school satisfaction and well-being had the greatest positive direct effect on both LS and SRH. Moreover, our results showed that the association between SES and LS was attributable to indirect effects through physical activity, ZBMI, social contact and sedentary time in boys and through sedentary time in girls. It means that higher SES is associated with more physical activity, BMI, social contact and sedentary time in children and adolescents which in turn could lead to more LS. On the other hand, family size showed slight indirect effect on LS through its negative effect on wellbeing and BMI. Physical activity and social contact were significantly higher in boys than in girls in our study. Previous studies also suggested that adolescent and adult males are more active than females in leisure-time, although not all were consistent [27, 28]. An explanation for this finding relies on the lack of appealing public places for physical activity practice for females in some countries. Moreover, cultural and religious beliefs can also have a significant impact on these differences. In consistence with our findings, previous studies have shown that satisfaction at school has positive effect on students’ satisfaction with life by decreasing both the school drop-out rate and disruptive behaviors [29, 30]. School satisfaction was shown to reduce the students’ illness, raising positive emotions, life satisfaction and academic success [31]. On average, subjects who have higher social contact, take part in physical activities, spend more time with family and friends seem to have greater satisfaction with life [5]. As expected, all factors which decrease psychosocial stress in adolescents including having good relationships with family and friends, positive school environment and higher SES can improve subjective well-being and LS [32,33,34,35]. The literature indicated that LS was predicted by variables related to population health and there was a strong correlation between LS and health behaviors [36,37,38]. It is suggested that the individuals with normal BMI reported more LS than obese person [39]. The study conducted by Ford et al. regarding the association of BMI with health-related quality of life showed that after adjusting for confounders, thin and obese people, had lower SRH and LS than people with normal BMI [39]. Furthermore, an inverse association was shown between LS with negative health-related behaviors such as physical inactivity [36]. These results are in line with our findings and show that appropriate BMI and physical activity as two main health behaviors seem to have positive effect on LS.

This study provides new evidence about the determinants of SRH and LS as important indicators for students’ health care in a large sample of Iranian children and adolescents. However, the cross-sectional design of this study had a limited ability for demonstrating a causal relationship and understanding the possible changes of subscales over time and their predictive validity. Moreover, self-report measure of some potentially important factors including personality variables, increases the risk of biases in this method. The variables related to mental health and satisfaction were also obtained through questionnaires, so these measurements may contain some errors and probability of misclassification is existed. Future studies with longitudinal design and several data collections are suggested in order to verify the main determinants of life satisfaction in children and adolescents to improve health, both in adolescence and later in life.

Conclusion

The findings of the current study indicated that LS and SRH of children and adolescents are directly or indirectly affected by many factors including age, physical activity, socio economic status, sleep duration, well-being, family size, social contacts, sedentary time and school satisfaction. Among these variables school satisfaction had the greatest positive direct effect on both LS and SRH. Therefore, it needs to notice the significance of these factors on the life and health satisfaction of children and adolescents and health-promoting programs should be designed according to the observed associations to improve their health outcomes.

Availability of data and materials

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

BMI:

body mass index

LS:

Life satisfaction

PA:

Physical activity

SES:

Socioeconomic status

SRH:

self-rated health

ST:

Sedentary time

References

  1. Sawyer SM, Afifi RA, Bearinger LH, Blakemore S-J, Dick B, Ezeh AC, et al. Adolescence: a foundation for future health. Lancet. 2012;379(9826):1630–40.

    Article  Google Scholar 

  2. Currie C. Social determinants of health and well-being among young people. HBSC international report from the 2009/2010 survey. Policy for Children and Adolescents, No. 6. Prieiga per internetą (žiūrėtą: 201311 08).

  3. Adamson P, Bradshaw J, Hoelscher P, Richardson D. Child poverty in perspective: an overview of child well-being in rich countries. Innocenti Report Card. 2007;7:UNICEF.

    Google Scholar 

  4. Kelishadi R, Djalalinia S, Qorbani M, Mansourian M, Motlagh ME, Ardalan G, et al. Self-rated health and life satisfaction in Iranian children and adolescents at the national and provincial level: the CASPIAN-IV study. Iran Red Crescent Med J. 2016;18(12).

  5. Branch-Allen R, Jayachandran J, editors. Determinants of life satisfaction in Canada: A causal modeling approach. SHS web of conferences; 2016: EDP Sciences.

  6. Eriksson I, Undén A-L, Elofsson S. Self-rated health. Comparisons between three different measures. Results from a population study. Int J Epidemiol. 2001;30(2):326–33.

    Article  CAS  Google Scholar 

  7. Veenhoven R. Developments in satisfaction-research. Soc Indic Res. 1996;37(1):1–46.

    Article  Google Scholar 

  8. Blanchflower DG, Oswald AJ. Well-being over time in Britain and the USA. J Public Econ. 2004;88(7–8):1359–86.

    Article  Google Scholar 

  9. Siahpush M, Spittal M, Singh GK. Happiness and life satisfaction prospectively predict self-rated health, physical health, and the presence of limiting, long-term health conditions. Am J Health Promot. 2008;23(1):18–26.

    Article  Google Scholar 

  10. Streiner DL. Finding our way: an introduction to path analysis. Can J Psychiatry. 2005;50(2):115–22.

    Article  Google Scholar 

  11. Motlagh ME, Ziaodini H, Qorbani M, Taheri M, Aminaei T, Goodarzi A, et al. Methodology and early findings of the fifth survey of childhood and adolescence surveillance and prevention of adult noncommunicable disease: the CASPIAN-V study. Int J Prev Med. 2017;8.

  12. Status WP. The use and interpretation of anthropometry: report of a World Health Organization (WHO) expert committee. Geneva: World Health Organization; 1995.

    Google Scholar 

  13. Kelishadi R, Majdzadeh R, Motlagh M-E, Heshmat R, Aminaee T, Ardalan G, et al. Development and evaluation of a questionnaire for assessment of determinants of weight disorders among children and adolescents: the Caspian-IV study. Int J Prev Med. 2012;3(10):699.

    PubMed  PubMed Central  Google Scholar 

  14. Ahadi Z, Qorbani M, Kelishadi R, Ardalan G, Taslimi M, Mahmoudarabi M, et al. Regional disparities in psychiatric distress, violent behavior, and life satisfaction in Iranian adolescents: the CASPIAN-III study. J Dev Behav Pediatr. 2014;35(9):582–90.

    Article  Google Scholar 

  15. Kelishadi R, Motlagh ME, Roomizadeh P, Abtahi S-H, Qorbani M, Taslimi M, et al. First report on path analysis for cardiometabolic components in a nationally representative sample of pediatric population in the Middle East and North Africa (MENA): the CASPIAN-III study. Ann Nutr Metab. 2013;62(3):257–65.

    Article  CAS  Google Scholar 

  16. Kelishadi R, Majdzadeh R, Motlagh ME, Heshmat R, Aminaee T, Ardalan G, et al. Development and evaluation of a questionnaire for assessment of determinants of weight disorders among children and adolescents: the Caspian-IV study. Int J Prev Med. 2012;3(10):699.

    PubMed  PubMed Central  Google Scholar 

  17. Kelishadi R, Ardalan G, Qorbani M, Ataie-Jafari A, Bahreynian M, Taslimi M, et al. Methodology and early findings of the fourth survey of childhood and adolescence surveillance and prevention of adult non-communicable disease in Iran: the CASPIAN-IV study. Int J Prev Med. 2013;4(12):1451.

    PubMed  PubMed Central  Google Scholar 

  18. Tremblay MS, Aubert S, Barnes JD, Saunders TJ, Carson V, Latimer-Cheung AE, et al. Sedentary behavior research network (SBRN)–terminology consensus project process and outcome. Int J Behav Nutr Phys Act. 2017;14(1):1–17.

    Article  Google Scholar 

  19. Cohen J, Cohen P, West SG, Aiken LS. Applied multiple regression/correlation analysis for the behavioral sciences. Routledge. 2013.

  20. Wolfle LM. Strategies of path analysis. Am Educ Res J. 1980 Mar;17(2):183–209.

    Article  Google Scholar 

  21. Kline RB. Principles and practice of structural equation modeling: Guilford Publications; 2015.

  22. Warnoff C, Lekander M, Hemmingsson T, Sorjonen K, Melin B, Andreasson A. Is poor self-rated health associated with low-grade inflammation in 43110 late adolescent men of the general population? A cross-sectional study. BMJ Open. 2016;6(4):e009440.

    Article  Google Scholar 

  23. Keyes CL. Happiness, flourishing, And life satisfaction. The Wiley Blackwell encyclopedia of health, illness, behavior, and society. 2014:747–51.

  24. Diener E, Emmons RA, Larsen RJ, Griffin S. The satisfaction with life scale. J Pers Assess. 1985;49(1):71–5.

    Article  CAS  Google Scholar 

  25. Palgi Y, Shmotkin D. The predicament of time near the end of life: time perspective trajectories of life satisfaction among the old-old. Aging Ment Health. 2010;14(5):577–86.

    Article  Google Scholar 

  26. Marques A, Peralta M, Santos T, Martins J, Gaspar de Matos M. Self-rated health and health-related quality of life are related with adolescents' healthy lifestyle. Public Health. 2019;170:89–94.

    Article  CAS  Google Scholar 

  27. Kelley GA. Gender differences in the physical activity levels of young African-American adults. J Natl Med Assoc. 1995;87(8):545–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  28. Azevedo MR, Araújo CL, Reichert FF, Siqueira FV, da Silva MC, Hallal PC. Gender differences in leisure-time physical activity. Intl J Public Health. 2007;52(1):8–15.

    Article  Google Scholar 

  29. Lewis AD, Huebner ES, Malone PS, Valois RF. Life satisfaction and student engagement in adolescents. J Youth Adolesc. 2011;40(3):249–62.

    Article  Google Scholar 

  30. Elmore GM, Huebner ES. Adolescents' satisfaction with school experiences: relationships with demographics, attachment relationships, and school engagement behavior. Psychol Sch. 2010;47(6):525–37.

    Article  Google Scholar 

  31. Takakura M, Wake N, Kobayashi M. The contextual effect of school satisfaction on health-risk behaviors in Japanese high school students. J Sch Health. 2010;80(11):544–51.

    Article  Google Scholar 

  32. Addae EA. The mediating role of social capital in the relationship between socioeconomic status and adolescent wellbeing: evidence from Ghana. BMC Public Health. 2020;20(1):20.

    Article  Google Scholar 

  33. Patel V, Flisher AJ, Hetrick S, McGorry P. Mental health of young people: a global public-health challenge. Lancet. 2007;369(9569):1302–13.

    Article  Google Scholar 

  34. DuBois DL, Silverthorn N. Natural mentoring relationships and adolescent health: evidence from a national study. Am J Public Health. 2005;95(3):518–24.

    Article  Google Scholar 

  35. Freeman J, King M, Kuntsche E, Pickett W. Protective roles of home and school environments for the health of young Canadians. J Epidemiol Community Health. 2011;65(5):438–44.

    Article  Google Scholar 

  36. Strine TW, Chapman DP, Balluz LS, Moriarty DG, Mokdad AH. The associations between life satisfaction and health-related quality of life, chronic illness, and health behaviors among US community-dwelling adults. J Community Health. 2008;33(1):40–50.

    Article  Google Scholar 

  37. Grant N, Wardle J, Steptoe A. The relationship between life satisfaction and health behavior: a cross-cultural analysis of young adults. Intl J Behav Med. 2009;16(3):259–68.

    Article  Google Scholar 

  38. Karyani AK, Matin BK, Gebru AA, Dizaj JY, Rezaei S. Life and health satisfaction and their association toward health-related quality of life, body mass index and chronic diseases in Iran. Journal of education and health promotion 2019;8.

  39. Wee HL, Cheung YB, Loke WC, Tan CB, Chow MH, Li SC, et al. The association of body mass index with health-related quality of life: an exploratory study in a multiethnic Asian population. Value Health. 2008;11:S105–S14.

    Article  Google Scholar 

Download references

Acknowledgements

The authors are thankful of all participants and large team working on this project in different provinces. We appreciate Isfahan University of Medical Sciences and other relevant national regulatory organizations (Project number: 194049) for supporting this project. The funder had only supporting role in this project.

Funding

This study was funded by Isfahan University of Medical Sciences.

Author information

Authors and Affiliations

  1. Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

    Pooneh Angoorani & Ramin Heshmat

  2. Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran

    Zohreh Mahmoodi

  3. Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

    Hanieh-Sadat Ejtahed

  4. Department of Pediatrics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

    Mohammad Esmaeil Motlagh

  5. Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran

    Mostafa Qorbani

  6. Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

    Mostafa Qorbani

  7. Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran

    Roya Kelishadi

Authors
  1. Pooneh Angoorani
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zohreh Mahmoodi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hanieh-Sadat Ejtahed
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ramin Heshmat
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mohammad Esmaeil Motlagh
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Mostafa Qorbani
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Roya Kelishadi
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

The concept of this study was proposed by M.Q., R.K., This study was designed by R.H., M.Q., R.K., Data collection or processing was done by R.H., M.E.M., Z.M., P.A., H.-S.E., Analysis or interpretation was performed by H.-S.E., M.Q., P.A, Z.M. Literature search was done by H.-S.E., M.Q., P.A. This study was written by H.-S.E., P.A. All authors have read and approved the manuscript.

Corresponding author

Correspondence to Mostafa Qorbani.

Ethics declarations

Ethics declarations and consent to participate

The study protocol was approved by the Research and Ethics Council of Isfahan University of Medical Sciences (code: 194049). Written informed consent and verbal assent were obtained from all the parents and students, respectively. This study was conducted according to the guidelines laid down in the Declaration of Helsinki, and all procedures involving human subjects were approved by Ethics Committee of Isfahan University of Medical Sciences.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Angoorani, P., Mahmoodi, Z., Ejtahed, HS. et al. Determinants of life satisfaction and self-rated health in Iranian children and adolescents: a structure equation model. BMC Pediatr 22, 4 (2022). https://doi.org/10.1186/s12887-021-03044-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1186/s12887-021-03044-w

Keywords

BMC Pediatrics

ISSN: 1471-2431

Contact us