population well-being in mashhad: mental health distribution and demographic gradients

Objective: positive mental health is a distinct dimension of population health. despite the validation of the persian mental health continuum–short form (mhc-sf), population-based estimates for adult municipal surveillance in iran are limited. to describe mhc-sf score distributions, internal consistency, and demographic gradients among adults in mashhad.method: a population-based cross-sectional survey (may 2024–march 2025) used stratified cluster sampling across five health districts (50 clusters; kish-grid household selection). adults aged ≥ 18 years completed the 14-item persian mhc-sf indexing emotional well-being (ewb), social well-being (swb), and psychological well-being (pwb).results: among 2,066 adults (57.6% women), the overall mean (sd; median) mhc-sf score was 61.55 (13.21; 63), with domain scores of 28.99 (6.19; 30) for pwb, 19.01 (5.63; 19) for swb, and 13.54 (4.11; 14) for ewb. men scored slightly higher than women on the total scale, ewb, and pwb (all p < 0.001; small effect sizes), while the swb difference was not statistically significant (p = 0.075). age showed weak positive associations with total, ewb, and swb scores (ρ = 0.060–0.069; p ≤ 0.006), but not pwb (ρ = 0.018; p = 0.408). item-level contrasts suggested higher male endorsement of agency/meaning indicators and higher female endorsement of benevolence/collective optimism; both sexes reported high levels of warm, trusting relationships. in a multivariable linear regression adjusting for age and sex simultaneously, demographic predictors accounted for < 1% of outcome variance, with male sex independently associated with higher total, ewb, and pwb scores, and age independently associated with slightly higher total, ewb, and swb scores.conclusion: in this representative urban population-based study, positive mental health was moderately high; pwb ranked highest, while swb lagged. demographic gradients were small: men slightly exceeded women, and older adults reported marginally higher ewb and swb. for surveillance, the mhc-sf total score appears suitable as a summary indicator, while the swb profile may help identify community-level levers (e.g., social capital and trust) to strengthen social connectedness in mashhad, iran.