Unpacking the Mechanisms Linking Generalized Anxiety Symptoms and Global Subjective Health Status among Artisanal Miners in Ghana

Anxiety symptoms is a prevalent psychiatric symptom among artisanal miners in low- and middle-income countries, yet its implications for perceived health status remain poorly understood. This study examined the association between anxiety symptoms and self-rated health (SRH) among artisanal miners in Ghana and assessed the mediating roles of perceived stress and depressive symptoms in this link. We analyzed data from a cross-sectional survey conducted in Ghana among 664 artisanal miners (mean age = 29.1 years, SD = 7.8; 83.7% male) aged ≥ 18 years. Anxiety symptoms was assessed using the Generalized Anxiety Disorder-7 scale, while SRH was measured using five items adapted from the Medical Outcomes Study Short Form-36. Multivariable ordinary least squares regression, and mediation analysis (using PROCESS macro, model 4) were fitted to test associations. After full adjustment, higher generalized anxiety levels were positively and significantly associated with suboptimal/poor self-rated health (B = 0.45, p < .001). This significant association was evident in both miners aged ≥36 years (B=1.61, p < 0.001) and those in the 18–35 age group (B = 0.54, p < 0.001). Mediation analyses indicated that perceived stress (9.2%) and depressive symptoms (24.7%) partially explained the association between generalized anxiety symptoms and miners’ perceived health status. Generalize anxiety symptoms is a significant determinant of perceived health status among artisanal miners in Ghana, possibly operating through stress and depressive symptomatology. Targeted mental health interventions addressing anxiety, stress, and depressive symptoms are therefore essential to improve miners’ wellbeing and occupational health outcomes in Ghana and related contexts. • What is the primary question addressed by this study? To what extent are generalized anxiety symptoms associated with poor self-rated health among artisanal and small-scale miners in Ghana, and do perceived stress and depressive symptoms mediate this relationship? • What is the main finding of this study? Higher anxiety is positively and significantly associated with poorer self-rated health, with depressive symptoms and perceived stress mediating 33.9% of this association. • What is the meaning of the finding? Targeted mental health interventions should address anxiety, stress, and depression collectively, as addressing anxiety alone may be insufficient to improve health outcomes in vulnerable mining populations. • What is the novelty of this study? This is one of the first studies to empirically examine psychosocial pathways linking anxiety to self-rated health among artisanal miners in a sub-Saharan African context.