Are confidence in self and the healthcare system plausible pathways linking chronic conditions to subjective health and wellbeing?

Abstract Chronic conditions are known to reduce subjective wellbeing (SWB) and self-rated health (SRH), yet the mechanisms underlying these effects remain poorly understood. Using nationally representative Australian data (2011: N = 1946; 2021: N = 1050), we examined whether psychological self-confidence (SC) and confidence in the healthcare system (HSC) are associated with these outcomes above and beyond chronic condition status, drawing on Weems’ Associational Variable Analysis framework. Chronic condition status was significantly and negatively associated with SRH (2011: β = –0.826; 2021: B = –0.597) and SWB (2011: β = –0.371; 2021: β = –0.250). SC positively associated with both SRH (2011: β = 0.239; 2021: β = 0.287) and SWB (2011: β = 0.584; 2021: β = 0.570), explaining a substantial share of variance in these outcomes beyond chronic condition status (SRH: 11–14%; SWB: 63–64%). HSC contributed smaller but significant associations with both outcomes. These patterns were broadly consistent across both survey waves. Although temporal ordering and causality cannot be established due to the cross-sectional nature of the data, the results generate the hypotheses that both SC and HSC may help explain the association between chronic condition status and SRH and SWB in Australia, a proposition that awaits testing with longitudinal data and appropriate causal designs.