SHORT COMMUNICATION Mental Well-Being Mediates the Relationship between Perceived Stress and Perceived Health Hui Chian Teh 1 , Josephine A. Archer 1 , Weining Chang 2 & SH Annabel Chen 1 * † 1 Nanyang Technological University, Singapore 2 Duke-NUS Graduate School of Medicine, Singapore Abstract The association between stress and health has been well researched in the past; however, comparatively few medi- ators have been tested to understand the underlying mechanism. With increasing awareness on mental well-being, this study evaluated the relationship between perceived stress and perceived health and examined mental well-being as a mediator. Two-hundred undergraduates aged 21 to 26 years completed the English Perceived Stress Scale, Health Status Questionnaire and Asian Mental Well-Being Scale that assess perceived stress, perceived health and mental well-being, respectively. Factor analysis and structural equation modelling on the Perceived Stress Scale rep- licated the reported two-factor structure after excluding an insignificant item. Linear multiple regression analyses indicated that perceived stress was negatively associated with perceived health. Results showed that mental well-being partially mediated the relationship between perceived stress and perceived health, although it is acknowl- edged that this association could be bidirectional. Findings from the present study suggest that future research could focus on reducing stress and improving mental well-being to alleviate the effect of stress on health. Copyright © 2013 John Wiley & Sons, Ltd. Received 22 March 2013; Revised 7 June 2013; Accepted 7 June 2013 Keywords perceived stress; mental well-being; mediation; perceived health; validation *Correspondence SH Annabel Chen, Division of Psychology, Nanyang Technological University, 14 Nanyang Drive, HSS-04-19, Singapore 637332, Singapore. † Email: annabelchen@ntu.edu.sg Published online 30 July 2013 in Wiley Online Library (wileyonlinelibrary.com) DOI: 10.1002/smi.2510 Introduction Many studies have indicated a strong relationship between stress and health (Boey, Chan, Ko, Goh, & Lim, 1997; Cohen, Tyrrell, & Smith, 1993; Fuller, Edwards, Vorakitphokatorn, & Sermsri, 1996; Gayman, Brown, & Cui, 2011). These results are based on many dif- ferent measures of stress, e.g. stress hormone levels and life event scales. Few studies have investigated the importance of perceived stress levels, despite evidence indicating the sensitivity of perceived stress in relation to health out- comes (Burns, Drayson, Ring and Carroll, 2002). Findings from previous studies investigating the relationship between perceived stress and perceived health have been mixed. An older study on a Swiss population reported that perceived stress was not corre- lated with subjective health rating (Gehring, Aubert, Padlina, Martin-Diener, & Somaini, 2001). Conversely, Leung, Lam, and Chan (2010) found a significant negative correlation between perceived health status and perceived stress. Potential mediators of the association between stress and health have been examined, including coping (Connor-Smith & Compas, 2002), sense of coherence (Gana, 2001) and self-efficacy (Maciejewski, Prigerson, & Mazure, 2000). This study proposes mental well- being as a potential mediator. Stress, mental well-being and health Interest in the construct of mental well-being has increased among policymakers and researchers in recent years (Anderson, Jané-Llopis and Cooper, 2011; Depart- ment of Health, 2009; Health Promotion Board, 2010). It has been found to be inversely related to perceived stress in students and women (Sugiura, Shinada, & Kawaguchi, 2005; Young et al., 2004). Poor mental well-being has also been found to be associated with poor health (Heidrich, 1993) as well as lower health perception (Piko, 2000); mental well-being was the strongest predictor of self-perceived health status among the young population compared with factors such as physical activity, acute illness and psychosomatic symptoms (such as headache and sleeping problems) (Piko, 2000). In keeping with the negative association between perceived stress and mental well-being, and 71 Stress Health 31: 71–77 (2015) © 2013 John Wiley & Sons, Ltd.