The Association Between Self-Surveillance and Self-Rated Health in College Women: A Mechanistic Approach

Although women outlive men, women report poorer self-rated physical health over much of the lifespan. Objectification theory may offer insight into this gender difference. Objectifying culture promotes self-surveillance, which encourages prioritizing the body’s appearance over its physical functioning and well-being. As women may engage in self-surveillance more so than men, this sequence of events may help explain this gender difference in self-rated health. However, the few studies examining this idea show an inconsistent relationship between self-surveillance and self-rated health. Nonetheless, self-surveillance may promote body shame and diminished awareness of internal bodily states. As these factors are associated with poor self-rated health, self-surveillance may predict poor self-rated health via these mechanisms. In study 1 ( N = 166 undergraduate women), self-surveillance was unrelated to self-rated health. However, body shame and low interoceptive awareness mediated this relationship. In study 2 ( N = 347 undergraduate women and men), self-surveillance correlated negatively with self-rated health for female participants but not male participants. Female participants reported poorer self-rated health, and this effect was serially mediated by self-surveillance, body shame, and low body responsiveness. These studies suggest a potential avenue by which self-surveillance may explain the gender difference in self-rated health in college samples, providing an important basis for future longitudinal investigations in more diverse samples. Moreover, these results suggest that interventions targeting body shame and low internal awareness may be used to promote good self-rated health as well as to prevent disease and poor health behaviors related to self-rated health.