Associations Between General Health, Self-Esteem, and Academic Stress Among Medical Students: A Multicenter Cross-sectional Study in Iran

Background: It is important to monitor the general health of medical students, as they are future healthcare professionals who will interact with large populations. This study was conducted to examine the association between self-esteem, academic stress, and general health among medical students. Methods: This descriptive cross-sectional multicenter study was conducted from October 2024 to December 2024. A total of 170 medical students from three medical universities in southern Iran were recruited via convenience sampling. Data were collected using a demographic information form, the Goldberg General Health Questionnaire (GHQ), Rosenberg Self-Esteem Scale (RSES), Generalizability Analysis (GA), and Gadzella’s Student-Life Stress Inventory (SLSI). Data were analyzed using SPSS version 23, which involved the use of descriptive statistics, ANOVA, chi-square tests, and multiple linear regression. Results: The mean age of participants was 24.9±1.64 years. The majority were female (64.7%), single (83.3%), dormitory residents (79.1%), and externs (37.6%). The mean and standard deviation scores for general health, self-esteem, and academic stress were 22.7±13.9, -4.8±4.0, and 128.8±19.4, respectively. Among the participants, 24.9% were at risk of mental health disorders, 80.9% had low self-esteem, and 81.6% reported moderate levels of academic stress. General health was significantly positively correlated with self-esteem (r=0.53, P=0.02) and negatively correlated with academic stress (r=-0.28, P=0.001). In addition, there was an inverse relationship between self-esteem and academic stress (r=-0.29, P=0.01). Academic stress, self-esteem, gender, and academic level were significant predictors of general health, accounting for 37% of the variance in general health scores. Conclusion: The prevalence of low self-esteem and moderate academic stress among medical students underscores the urgent need for targeted interventions. Since both self-esteem and academic stress are modifiable factors, it is recommended that educational administrators and health policymakers implement structured mental health support programs, stress management workshops, and resilience-building programs to improve students’ well-being. Future studies should explore the longitudinal impacts and evaluate the effectiveness of such interventions.