Physical and psychological health of medical students: A structural equation modeling approach

Objective: This study aims to expand the application of behavioral immune system theory during public health emergencies and explore potential strategies to avoid “health poverty” in the post-pandemic era, focusing on Chinese medical students.
Methods: A comprehensive conceptual model was developed based on behavioral immune system theory. Data were collected through a cross-sectional survey conducted between September 2020 and June 2021, involving 1015 medical students in China.
Results: The findings revealed significant associations among emotional responses, strong beliefs, behavioral immune responses, and psychological outcomes. Notably, behavioral immune responses were significantly associated with sleep quality (β = 0.452), appetite (β = 0.501), and the tendency to seek psychological knowledge (β = 0.408). The dissemination of epidemic-related information was negatively associated with emotional responses (β = −0.207), strong beliefs (β = −0.369), and behavioral immune responses (β = −0.357), while positively linked to the formation of virtual beliefs. Behavioral immune responses showed a significant negative association with mental health (β = −0.546). Emotional responses were positively associated with strong beliefs (β = 0.660), which in turn were positively associated with behavioral immune responses (emotional response: β = 0.724; virtual beliefs: β = 0.877).
Conclusions: The persistent spread of epidemic-related information may adversely affect the physical and mental health of medical students, potentially contributing to a “hidden crisis.” If left unaddressed, such psychological impacts could increase the risk of “health poverty” among low- and middle-income populations in the postpandemic era.
© 2025 The Authors. Published by Elsevier B.V.