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Ran X, Zhang X, Gong W, Chen G. The association between socioeconomic status perception and mental health among Chinese older adults: the mediating roles of social trust and justice. BMC Geriatr 2024; 24:499. [PMID: 38844836 PMCID: PMC11157710 DOI: 10.1186/s12877-024-04968-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 04/12/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Mental health is a matter of quality of life among older adults. This study aimed to explore the association between the socioeconomic status (SES) perception and mental health of older adults using data from 2017 Chinese General Social Survey (CGSS). METHODS Ordinary least squares (OLS) regression was used to analyse the association between SES perception and mental health, and the substitution model and variable methods were used to check the robustness of the results. Moreover, we adopted the Sobel model to analyse the mediating roles of social trust and justice. RESULTS SES perception was positively associated with mental health, and this association was mediated by social trust and justice. This kind of positive association was mainly embodied in those groups with the highest or lowest objective SES. In other words, this study confirmed the phenomenon of "a contented mind is a perpetual feast" in Chinese society. CONCLUSIONS Higher SES perception is associated with improved mental health for Chinese older adults. It is imperative to prioritize efforts to enhance the perceptual abilities of older adults, particularly those with the highest or lowest objective SES, to promote their overall subjective well-being.
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Affiliation(s)
- Xiaoxing Ran
- Institute of Population Research, Peking University, 100871, Beijing, China
| | - Xiaodong Zhang
- Institute of Population Research, Peking University, 100871, Beijing, China
- Oxford Institute of Population Ageing, University of Oxford, OX2 6PR, Oxford, UK
| | - Wenyi Gong
- Institute of Population Research, Peking University, 100871, Beijing, China
| | - Gong Chen
- Institute of Population Research, Peking University, 100871, Beijing, China.
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2
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Park H, Kim J. Perceived social position, active engagement with life, and depressive symptoms among older adults. Soc Sci Med 2024; 345:116716. [PMID: 38428091 DOI: 10.1016/j.socscimed.2024.116716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 02/12/2024] [Accepted: 02/20/2024] [Indexed: 03/03/2024]
Abstract
RATIONALE Despite the existing literature on the relationship between perceived social position (PSP) and depressive symptoms, there remain gaps in our understanding, particularly regarding the potential for asymmetric effects of increases and decreases in PSP and the underlying mechanisms involved. OBJECTIVE This study aims to examine whether increases and decreases in PSP are differentially associated with depressive symptoms and to explore the potential mediating role of active engagement with life in these associations. METHODS This study utilized data from the Korean Longitudinal Study of Aging (KLoSA), collected between 2008 and 2018, involving a sample of 3506 individuals aged 65 or older. Asymmetric fixed effects (FE) models were employed, which enable the estimation of differential effects for increases and decreases in PSP, while accounting for unobserved individual-level heterogeneity. To assess the mediating role of active engagement in life, Sobel mediation tests were conducted. RESULTS The asymmetric FE estimates revealed a stronger association between decreases in PSP and increases in depressive symptoms compared to the association between increases in PSP and decreases in depressive symptoms. The Sobel mediation tests indicated that formal social activities had the most substantial mediating effect, explaining 14% and 9% of the total effect mediated for increased and decreased PSP and depressive symptoms, respectively. Leisure/hobby activities explained 10% and 4% of the total effect mediated for increased and decreased PSP and depressive symptoms, respectively. CONCLUSION This study provides evidence that increases and decreases in PSP have differential effects on depressive symptoms among older adults in Korea. Policy interventions aimed at improving the psychological well-being of older adults should prioritize efforts to both enhance PSP and minimize declines, as the latter can have a stronger negative impact on depressive symptoms. Active engagement in life may serve as a potential pathway for achieving the desired effects.
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Affiliation(s)
- HyunJee Park
- Department of Health Policy and Management, Korea University, Seoul, Republic of Korea; Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea; Korea Institute for Health and Social Affairs, Sejong, Republic of Korea
| | - Jinho Kim
- Department of Health Policy and Management, Korea University, Seoul, Republic of Korea; Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea; Center for Demography of Health and Aging, University of Wisconsin-Madison, Madison, WI, USA.
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Hernández-Pacheco R, Steiner UK, Rosati AG, Tuljapurkar S. Advancing methods for the biodemography of aging within social contexts. Neurosci Biobehav Rev 2023; 153:105400. [PMID: 37739326 PMCID: PMC10591901 DOI: 10.1016/j.neubiorev.2023.105400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 08/10/2023] [Accepted: 09/18/2023] [Indexed: 09/24/2023]
Abstract
Several social dimensions including social integration, status, early-life adversity, and their interactions across the life course can predict health, reproduction, and mortality in humans. Accordingly, the social environment plays a fundamental role in the emergence of phenotypes driving the evolution of aging. Recent work placing human social gradients on a biological continuum with other species provides a useful evolutionary context for aging questions, but there is still a need for a unified evolutionary framework linking health and aging within social contexts. Here, we summarize current challenges to understand the role of the social environment in human life courses. Next, we review recent advances in comparative biodemography and propose a biodemographic perspective to address socially driven health phenotype distributions and their evolutionary consequences using a nonhuman primate population. This new comparative approach uses evolutionary demography to address the joint dynamics of populations, social dimensions, phenotypes, and life history parameters. The long-term goal is to advance our understanding of the link between individual social environments, population-level outcomes, and the evolution of aging.
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Affiliation(s)
- Raisa Hernández-Pacheco
- Department of Biological Sciences, California State University, Long Beach, 1250 N Bellflower Blvd, Long Beach, CA 90840-0004, USA.
| | - Ulrich K Steiner
- Freie Universität Berlin, Biological Institute, Königin-Luise Str. 1-3, 14195 Berlin, Germany
| | - Alexandra G Rosati
- Departments of Psychology and Anthropology, University of Michigan, 530 Church St, Ann Arbor, MI 48109, USA
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Owens C, Hadley C. Subjective social status and mental health among adolescents in Ethiopia: Evidence from a panel study. SSM Popul Health 2023; 22:101382. [PMID: 36992716 PMCID: PMC10041554 DOI: 10.1016/j.ssmph.2023.101382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/15/2023] [Accepted: 03/13/2023] [Indexed: 03/17/2023] Open
Abstract
Numerous studies have found that a relationship between subjective status and measures of human health persists even after controlling for objective measures, including income, education, and assets. However, few studies have probed how status shapes health among adolescents, particularly those in low-and-middle-income settings. This study examines the relative effects of subjective and objective status on mental health among Ethiopian adolescents. Using data from two waves of the Jimma Longitudinal Family Survey of Youth (N = 1,045), this study uses a combination of linear regression and linear mixed-effects models to examine the relationships between objective social status, subjective social status, and mental well-being among adolescents in Ethiopia. Three measures of objective status, including household income, adolescent education, and a multidimensional measure of material wealth, were assessed. Social network and support variables were constructed using factor analysis. A community version of the 10-rung McArthur ladder was used to assess the subjective socioeconomic status of adolescents. The self-reporting questionnaire was used to assess mental well-being during both waves of the study. The significant effect of higher subjective status on reports of fewer non-specific psychological distress (-0.28; 95% CI: -0.43 to -0.14) was not mediated by objective status, material deprivation, or social support covariates. The observed relationship between status and mental well-being was consistent across successive study waves. Among a cohort of adolescents in Jimma, Ethiopia, several measures of objective status are associated with subjective status. However, akin to research among adults, the findings of our study suggest that the relationship between adolescent subjective social status and mental health persists above and beyond the effects of objective status. Future research is needed on the factors, environments, and experiences that inform adolescent perceptions of status and well-being over time.
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Hazell M, Thornton E, Haghparast-Bidgoli H, Patalay P. Socio-economic inequalities in adolescent mental health in the UK: Multiple socio-economic indicators and reporter effects. SSM - MENTAL HEALTH 2022. [DOI: 10.1016/j.ssmmh.2022.100176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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Ran X, Huang T, Chen G. Subjective Socioeconomic Status, Class Mobility and Health Disparities of Older People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13955. [PMID: 36360833 PMCID: PMC9654853 DOI: 10.3390/ijerph192113955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/16/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
The aim of this study is threefold: (1) investigate the impact of subjective socioeconomic status on the health of older people with a further exploration of its extent, (2) explore the relationship between diverse class mobility trajectories and health disparities among older people, and (3) examine the health disparities among older people with different subjective socioeconomic statuses in groups of various class mobility. The data for this study came from the Chinese General Social Survey (CGSS) of 2017, and regression and moderation models are used. The results indicate that for each level of increase in the subjective socioeconomic status of older people, the health score significantly increased by 0.159. The health status of older people who experienced upward class mobility is significantly better than those who did not; therefore, different class mobility trajectories also shape health disparities. The moderation role of class mobility on the impact of subjective socioeconomic status on the health of older people is also confirmed. The results provide further support for the subjective socioeconomic status having a significant impact on the health of older people with different class mobility trajectories. An upward class mobility trajectory somewhat diminishes this influence. Therefore, policy interventions should be provided to enhance the subjective socioeconomic status of older people and increase their opportunities for upward class mobility.
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Affiliation(s)
| | | | - Gong Chen
- Correspondence: ; Tel.: +86-010-62755422
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7
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Upenieks L, Schieman S, Meiorin R. A protective rung on the ladder? How past and current social status shaped changes in health during COVID-19. SSM Popul Health 2022; 17:101060. [PMID: 35252531 PMCID: PMC8887974 DOI: 10.1016/j.ssmph.2022.101060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 02/27/2022] [Accepted: 02/27/2022] [Indexed: 11/21/2022] Open
Abstract
An emerging body of work has started to document population health consequences of the social and economic transformations during the COVID-19 pandemic. We consider an individual’s relative social position in the stratification system—subjective social status (SSS)—and assess how past (childhood) and current SSS predict change in self-rated health during the pandemic. Using two waves of data from the Canadian Quality of Work and Economic Life Study, we follow respondents between the onset of lockdown measures in March and May of 2020 (N = 1886). Drawing from the life course perspective and stress process model, we find that lower current SSS predicts a greater likelihood of being in stable poor health and reporting declining health. Lower past SSS predicts a higher chance of being in stable poor health indirectly through current SSS. And lower cumulative SSS that sums both past and present SSS also predicts stable poor health, while perceived upward mobility over time is associated with stable good health. This robust relationship between SSS and health in such a short time period of two months at the start of the COVID-19 pandemic provides an important glimpse into the influence that SSS has on population health. Using two waves of data from the Canadian Quality of Work and Economic Life Study, we follow respondents between the onset of lockdown measures in March and May of 2020 (N = 1886). Drawing from the life course perspective and stress process model, we find that lower current SSS predicts a greater likelihood of being in stable poor health and reporting declining health. Lower past SSS predicts a higher chance of being in stable poor health indirectly through current SSS. And lower cumulative SSS that sums both past and present SSS also predicts stable poor health, while perceived upward mobility over time is associated with stable good health.
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Affiliation(s)
- Laura Upenieks
- Baylor University Department of Sociology, USA
- Corresponding author. Department of Sociology, Baylor University, One Bear Place, 76798, USA.
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Olstad DL, Nejatinamini S, Vanderlee L, Livingstone KM, Campbell DJT, Tang K, Minaker LM, Hammond D. Are stress-related pathways of social status differentiation more important determinants of health inequities in countries with higher levels of income inequality? SOCIOLOGY OF HEALTH & ILLNESS 2022; 44:663-691. [PMID: 35261028 DOI: 10.1111/1467-9566.13445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 01/16/2022] [Accepted: 01/31/2022] [Indexed: 06/14/2023]
Abstract
We explored socioeconomic gradients in self-rated overall health (SROH) using indicators of materialist (educational attainment and perceived income adequacy) and psychosocial perspectives (subjective social status (SSS)) among adults living in countries with varying levels of income inequality, and the importance of psychosocial stress in mediating these associations. If psychosocial processes at the individual and societal levels correspond, associations between SSS and SROH should be higher among adults in countries with higher income inequality, and psychosocial stress should be a more important mediator of these associations. We used multigroup structural equation models to analyse cross-sectional data from the International Food Policy Study of adults (n = 22,824) in Australia, Canada, Mexico, the UK and the United States. Associations between SSS and SROH were not higher in more unequal countries, nor was psychosocial stress a more important mediator of these associations. Inequities in SROH in more unequal countries may not predominantly reflect stress-related pathways of social status differentiation.
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Affiliation(s)
- Dana Lee Olstad
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Sara Nejatinamini
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Lana Vanderlee
- Centre Nutrition, Santé et Société (Centre NUTRISS), Pavillon des Services, Université Laval École de Nutrition, Laval, Quebec, Canada
| | - Katherine M Livingstone
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - David J T Campbell
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Medicine, Cumming School of Medicine, University of Calgary Foothills Medical Centre, Calgary, Alberta, Canada
- Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Karen Tang
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Leia M Minaker
- Faculty of Environment, School of Planning, University of Waterloo, Waterloo, Ontario, Canada
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
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9
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Olstad DL, Nejatinamini S, Kirkpatrick SI, Vanderlee L, Livingstone KM, Campbell DJT, Tang K, Minaker LM, Hammond D. Stress-Related Poor Diet Quality Does Not Explain Socioeconomic Inequities in Health: A Structural Equation Mediation Analysis of Gender-Specific Pathways. J Acad Nutr Diet 2021; 122:541-554.e1. [PMID: 34626824 DOI: 10.1016/j.jand.2021.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 09/16/2021] [Accepted: 09/30/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Psychosocial stress and diet quality individually mediate associations between socioeconomic position (SEP) and health; however, it is not known whether they jointly mediate these associations. This is an important question because stress-related unhealthy eating is often invoked as an explanation for diet-related health inequities, particularly among women, seemingly with no empirical justification. OBJECTIVE This study examined whether psychosocial stress and diet quality jointly mediated associations between SEP and self-rated health in women and men. DESIGN Multiple mediating pathways were modeled using data from the cross-sectional International Food Policy Study. PARTICIPANTS AND SETTING Data were collected from 5,645 adults (aged 18 years or older) in Canada during 2018 and 2019. MAIN OUTCOME MEASURES Participants reported SEP using indicators of materialist (educational attainment and perceived income adequacy) and psychosocial pathways (subjective social status), along with psychosocial stress, dietary intake (to assess overall diet quality via Healthy Eating Index-2015 scores), and self-rated health. STATISTICAL ANALYSES PERFORMED Structural equation modeling modeled pathways linking SEP (ie, educational attainment, perceived income adequacy, and subjective social status) with self-rated health mediated by psychosocial stress and diet quality, stratified by gender. RESULTS There was no evidence that psychosocial stress and diet quality jointly mediated associations between SEP and self-rated health in women or men. Diet quality mediated associations between educational attainment and self-rated health in women and men, with some evidence that it mediated associations between subjective social status and self-rated health in men (P = 0.051). Psychosocial stress mediated associations between perceived income adequacy and self-rated health in women and men, and between subjective social status and self-rated health in women. CONCLUSIONS Although often invoked as an explanation for diet-related health inequities, stress-related poor diet quality did not mediate associations between SEP and self-rated health in women or men. Psychosocial stress and diet quality individually mediated some of these associations, with some differences by gender.
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Affiliation(s)
- Dana Lee Olstad
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
| | - Sara Nejatinamini
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Sharon I Kirkpatrick
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Lana Vanderlee
- Université Laval École de Nutrition, Centre Nutrition, Santé et Société (Centre NUTRISS), Québec, Québec, Canada
| | - Katherine M Livingstone
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - David J T Campbell
- Department of Medicine, Department of Community Health Sciences, Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary Foothills Medical Centre, Calgary, Alberta, Canada
| | - Karen Tang
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Leia M Minaker
- School of Planning, Faculty of Environment, University of Waterloo, Waterloo, Ontario, Canada
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
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Dougall I, Weick M, Vasiljevic M. Social class and wellbeing among staff and students in higher education settings: Mapping the problem and exploring underlying mechanisms. JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 2021. [DOI: 10.1111/jasp.12814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Isla Dougall
- Department of Psychology Durham University Durham UK
| | - Mario Weick
- Department of Psychology Durham University Durham UK
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11
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Race, Social Status, and Depressive Symptoms: A Moderated Mediation Analysis of Chronic Low Back Pain Interference and Severity. Clin J Pain 2021; 36:658-666. [PMID: 32487870 DOI: 10.1097/ajp.0000000000000849] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Chronic low back pain (cLBP) is the leading cause of disability, with a significant societal cost. It disproportionately affects non-Hispanic blacks and individuals of lower socioeconomic status. The biopsychosocial framework has been used to study and manage cLBP, yet disparities persist. OBJECTIVE The objective of this study was to assess whether self-identified race moderated the relationship between perceived social status and cLBP outcomes (pain interference and pain severity) and investigate whether race moderated the indirect relationship between perceived social status and pain outcomes via depressive symptoms. METHODS Fifty-seven blacks and 48 whites with cLBP were recruited as part of a large ongoing study. Depressive symptoms, objective and subjective measures of socioeconomic status, and pain outcomes were measured. Hayes' moderated mediation model was used to estimate conditional direct and indirect relationship between these variables. RESULT On average black participants reported significantly more pain interference (4.12 [SD=2.65] vs. 2.95 [SD=2.13]) and severity (5.57 [SD=2.27] vs. 3.99 [SD=1.99]) than white participants, (P<0.05). Race moderated the association between perceived social status and pain interference: higher social status decreases pain interference for white participants, but that trend was not observed in black participants. Moreover, race moderated association of perceived social status with depressive symptoms (P<0.001); which mediates the effects of perceived social status on pain outcomes. CONCLUSION Higher perceived social status is associated with less severe depressive symptoms, which in turn is associated with less pain severity and less pain interference for whites but not for blacks with cLBP.
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Ahrenfeldt LJ, Möller S. The Reciprocal Relationship between Socioeconomic Status and Health and the Influence of Sex: A European SHARE-Analysis Based on Structural Equation Modeling. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18095045. [PMID: 34068750 PMCID: PMC8126237 DOI: 10.3390/ijerph18095045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/06/2021] [Accepted: 05/07/2021] [Indexed: 01/19/2023]
Abstract
It is well recognized that socioeconomic status (SES) is an important determinant of health, but many studies fail to address the possibility of reverse causation. We aim to investigate the reciprocal relationship between trajectories of SES and health, and how these associations differ by sex. We performed a longitudinal study including 29,824 men and 37,263 women aged 50+ participating in at least two consecutive waves of the Survey of Health, Ageing and Retirement in Europe (SHARE). Using structural equation modeling, we found that baseline household income and wealth led to improvements in cognitive function, grip strength, quality of life and depressive symptoms, and a better initial health led to higher income and wealth for both sexes. However, the results indicated that the relative effect of cognitive function and grip strength on SES trajectories was overall greater than the corresponding effect of SES on health changes, particularly regarding income among women, but for quality of life and depressive symptoms, the reverse was indicated, though most pronounced for the associations with wealth. The reciprocal associations between SES and physical function were stronger for men than for women, whereas most associations with cognitive function and mental health were similar between sexes. This study demonstrates that both social causation and health selection contribute to social inequalities in health, but the influence of each direction and the importance of sex differences may vary according to the health outcomes investigated.
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Affiliation(s)
- Linda Juel Ahrenfeldt
- Unit for Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, 5000 Odense, Denmark
- Correspondence: ; Tel.: +45-6550-3844
| | - Sören Möller
- OPEN–Open Patient Data Explorative Network, Odense University Hospital, 5000 Odense, Denmark;
- Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark
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McClain AC, Gallo LC, Mattei J. Subjective Social Status and Cardiometabolic Risk Markers by Intersectionality of Race/Ethnicity and Sex Among U.S. Young Adults. Ann Behav Med 2021; 56:442-460. [PMID: 33942845 DOI: 10.1093/abm/kaab025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Subjective social status (SSS) has shown inverse relationships with cardiometabolic risk, but intersectionalities of race/ethnicity and sex may indicate more nuanced relationships. PURPOSE To investigate associations of SSS with cardiometabolic risk markers by race/ethnicity and sex. METHODS Data were from Wave IV (2008) of the National Longitudinal Study of Adolescent to Adult Health (n = 4,847; 24-32 years), which collected biological cardiometabolic risk markers. A 10-step ladder captured SSS; respondents indicated on which step they perceived they stood in relation to other people in the U.S. higher values indicated higher SSS (range: 1-10). We tested the relationship between SSS and individual markers using generalized least square means linear regression models, testing three-way interactions between SSS, race/ethnicity, and sex (p < .10) before stratification. RESULTS SSS-race/ethnicity-sex interactions were significantly associated with waist circumference (p ≤ .0001), body mass index (BMI; p ≤ .0001), systolic blood pressure (SBP; p ≤ .0001), diastolic blood pressure (DBP; p = .0004), and high-density lipoprotein cholesterol (HDL-C; p = .07). SSS was associated with waist circumference (β [SE]: -1.2 (0.4), p < .05) and BMI (-0.6 [0.2], p < .01) for non-Hispanic White females, compared with males; with HDL-C among non-Hispanic White (0.2 [0.1]; p < .05) and Hispanic (0.3 (0.1); p < .05) females, compared with males; with SBP for non-Hispanic Asian (1.7 [0.8]; p < .05) and Multiracial (1.8 [0.8]; p < .05), versus White, females; and with DBP for non-Hispanic Black (0.8 [0.3]; p < .01), versus White, males. CONCLUSIONS SSS was differentially related to cardiometabolic risk markers by race/ethnicity and sex, suggesting intersectional aspects. Clinical and research applications of SSS should consider race/ethnicity- and sex-specific pathways influencing cardiometabolic risk.
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Affiliation(s)
- Amanda C McClain
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Josiemer Mattei
- Department of Nutrition, T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
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Skajaa N, Ording AG, Darvalics B, Horvath-Puho E, Sørensen HT. Long-term mortality in young and middle-aged adults hospitalised with chronic disease: a Danish cohort study. BMJ Open 2020; 10:e038131. [PMID: 33046469 PMCID: PMC7552875 DOI: 10.1136/bmjopen-2020-038131] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To examine the long-term outcomes for patients hospitalised with chronic diseases at age 30, 40 or 50 years. DESIGN Nationwide, population-based cohort study. SETTING All Danish hospitals, 1979-1989, with follow-up through 2014. PARTICIPANTS Patients hospitalised during the study period with one, two or three or more chronic diseases and age-matched and sex-matched persons from the general population without chronic disease leading to hospitalisation: age-30 group: 13 857 patients and 69 285 comparators; age-40 group: 24 129 patients and 120 645 comparators; and age-50 group, 37 807 patients and 189 035 comparators. MAIN OUTCOME MEASURES Twenty-five-year mortality risks based on Kaplan-Meier estimates, years-of-life-lost (YLLs) and mortality rate ratios based on Cox regression analysis. YLLs were computed for each morbidity level, as well as in strata of income, employment, education and psychiatric conditions. RESULTS Twenty-five-year mortality risks and YLLs increased steadily with increasing number of morbidities leading to hospitalisation and age, but the risk difference with general population comparators remained approximately constant across age cohorts. In the age-30 cohort, the risk differences for patients compared with comparators were 35.0% (95% CI 32.5 to 37.5) with two diseases and 62.5% (54.3% to 70.3%) with three or more diseases. In the age-50 cohort, these differences were, respectively, 48.4% (47.4 to 49.3) and 61.7% (60.1% to 63.0%). Increasing morbidity burden augmented YLLs resulting from low income, unemployment, low education level and psychiatric conditions. In the age-30 cohort, YYLs attributable to low income were 2.4 for patients with one disease, 6.2 for patients with two diseases and 11.5 for patients with three or more diseases. CONCLUSIONS Among patients with multiple chronic diseases, the risk of death increases steadily with the number of chronic diseases and with age. Multimorbidity augments the already increased mortality among patients with low socioeconomic status.
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Affiliation(s)
- Nils Skajaa
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Anne Gulbech Ording
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Bianka Darvalics
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Henrik Toft Sørensen
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
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15
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Li J, Wang J, Li JY, Qian S, Jia RX, Wang YQ, Liang JH, Xu Y. How do socioeconomic status relate to social relationships among adolescents: a school-based study in East China. BMC Pediatr 2020; 20:271. [PMID: 32493261 PMCID: PMC7268251 DOI: 10.1186/s12887-020-02175-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 05/27/2020] [Indexed: 02/01/2023] Open
Abstract
Background A great number of studies have concentrated on the influence of socioeconomic status with health outcomes, but little on how socioeconomic status affects social relationship in adolescents’ families, peers and schools. This study aimed to clarify more detailed information on the connection between social relationships and different dimensions of socioeconomic status. Methods A school-based cross-sectional study was performed by 13–18 adolescents enrolled in East China from September, 2018 to May, 2019, which recruited 6902 students from junior and senior high schools and used the stratified random sampling method. Parent-child relationship (cohesion, expressiveness, conflict), peer relationship (interpersonal relationship, communication and interaction, social emotion) and student-teacher relationship (intimacy, support, satisfaction, conflict) were investigated. Besides, objective socioeconomic status (parental education and occupation, assessed by the adolescent) and subjective socioeconomic status (self-evaluation of family social class) were measured. More detailed information was used to clarify the link between social relationships and different dimensions of socioeconomic status. Results All five indicators of socioeconomic status were slightly positively correlated with the quality of social relationships (r ranged from 0.036 to 0.189, all p < 0.001), except that maternal education was not correlated with the conflict dimension of parent-child relationship. Standardized regression coefficients indicated that paternal education (β = 0.08) and occupation (β = 0.07) were the predictors of parent-child relationship. And peer relationship model revealed that the corresponding effect size was slightly stronger for subjective socioeconomic status (β = 0.10), whereas the maternal education had a slightly stronger correlation with student-teacher relationship (β = 0.07) relative to other indicators. Conclusions Adolescents with lower socioeconomic status had poorer social relationships compared to those with higher socioeconomic status. These findings have important public health implications for health policy makers to make sound decisions on resources allocation and services planning in improving adolescents’ social relationships and promoting health outcomes.
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Affiliation(s)
- Jing Li
- Department of Child and Adolescent Health, School of Public Health, Medical College of Soochow University, No.199 Ren Ai Road, Suzhou, Jiangsu, 215123, People's Republic of China
| | - Jing Wang
- Business School, Xi'an International Studies University, Xi'an, 710128, People's Republic of China
| | - Jia-Yu Li
- Department of Child and Adolescent Health, School of Public Health, Medical College of Soochow University, No.199 Ren Ai Road, Suzhou, Jiangsu, 215123, People's Republic of China
| | - Sheng Qian
- Department of Child and Adolescent Health, School of Public Health, Medical College of Soochow University, No.199 Ren Ai Road, Suzhou, Jiangsu, 215123, People's Republic of China
| | - Rui-Xia Jia
- Department of Social medicine, School of Public Health, Soochow University, Suzhou, Jiangsu, 215123, People's Republic of China
| | - Ying-Quan Wang
- Department of Social medicine, School of Public Health, Soochow University, Suzhou, Jiangsu, 215123, People's Republic of China
| | - Jing-Hong Liang
- Department of Child and Adolescent Health, School of Public Health, Medical College of Soochow University, No.199 Ren Ai Road, Suzhou, Jiangsu, 215123, People's Republic of China.,Department of Social medicine, School of Public Health, Soochow University, Suzhou, Jiangsu, 215123, People's Republic of China
| | - Yong Xu
- Department of Child and Adolescent Health, School of Public Health, Medical College of Soochow University, No.199 Ren Ai Road, Suzhou, Jiangsu, 215123, People's Republic of China. .,Department of Social medicine, School of Public Health, Soochow University, Suzhou, Jiangsu, 215123, People's Republic of China.
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16
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Bøe T, Petrie KJ, Sivertsen B, Hysing M. Interplay of subjective and objective economic well-being on the mental health of Norwegian adolescents. SSM Popul Health 2019; 9:100471. [PMID: 31720359 PMCID: PMC6839012 DOI: 10.1016/j.ssmph.2019.100471] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 08/16/2019] [Accepted: 08/18/2019] [Indexed: 11/29/2022] Open
Abstract
Objective and subjective socioeconomic status (SES) are important determinants of adolescent mental health problems, but we know less about how they interact. Research has demonstrated independent associations of both variables to mental health problems, but less is known about their relationship and role in adolescent mental health problems. Data from the youth@hordaland study, a survey of 9079 Norwegian adolescents aged 16 to 19 were linked to official tax register information about household income, and was used to examine the relationship between perceived economic well-being and household income. We also investigated how perceptions of economic well-being interacted with household income in relation to adolescent mental health problems. The overall relationship between perceived and actual household income was relatively low (r = .33 [95% CI = 0.32–0.35], p < .001, although this relationship was somewhat higher in adolescents with either low or high household incomes. Low income and unfavorable perceptions of economic well-being were associated with most mental health problems. Importantly, the mental health benefits associated with higher income appeared to depend on the adolescents' perceptions of their family's relative economic position. The results show moderate associations between perceived economic well-being and household income and that the influence of perceived economic well-being on conduct- and peer problems depended on the level of household income. Symptoms of depression explained some of this association. Knowledge about how the adolescents feel about their relative economic standing may be potentially important information for adolescents with mental health problems, and additional work is needed to understand how adolescents establish perceptions of economic rank.
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Affiliation(s)
- Tormod Bøe
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway.,NORCE Norwegian Research Centre AS, Regional Centre for Child and Youth Mental Health and Child Welfare, Bergen, Norway
| | - Keith J Petrie
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Børge Sivertsen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Department of Research and Innovation, Helse Fonna HF, Haugesund, Norway.,Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Mari Hysing
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway.,NORCE Norwegian Research Centre AS, Regional Centre for Child and Youth Mental Health and Child Welfare, Bergen, Norway
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17
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Weinberg D, Stevens GWJM, Duinhof EL, Finkenauer C. Adolescent Socioeconomic Status and Mental Health Inequalities in the Netherlands, 2001-2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193605. [PMID: 31561487 PMCID: PMC6801857 DOI: 10.3390/ijerph16193605] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 09/12/2019] [Accepted: 09/24/2019] [Indexed: 01/01/2023]
Abstract
Even in wealthy countries there are substantial socioeconomic inequalities in adolescent mental health. Socioeconomic status (SES) indicators—parental SES, adolescent subjective SES and adolescent educational level—are negatively associated with adolescent mental health problems, but little is known about the interplay between these SES indicators and whether associations have changed over time. Using data from the Dutch Health Behaviour in School-Aged Children (HBSC) studies (n = 27,020) between 2001 and 2017, we examined associations between three SES indicators and six indicators of adolescent mental health problems. Linear regressions revealed that adolescent subjective SES and adolescent educational level were independently negatively associated with adolescent mental health problems and positively associated with adolescent life satisfaction, but parental SES had negligible independent associations with adolescent mental health problems and life satisfaction. However, when interactions between SES indicators were considered, high adolescent subjective SES was shown to buffer the negative association between parental SES and adolescent mental health problems and the positive association between parental SES and life satisfaction. Despite societal changes between 2001 and 2017, socioeconomic inequalities in adolescent mental health were stable during this period. Findings suggest that all three SES indicators—parental SES, adolescent subjective SES and adolescent educational level—are important for studying socioeconomic inequalities in adolescent mental health.
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Affiliation(s)
- Dominic Weinberg
- Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht 3584 CH, The Netherlands.
| | - Gonneke W J M Stevens
- Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht 3584 CH, The Netherlands.
| | - Elisa L Duinhof
- Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht 3584 CH, The Netherlands.
| | - Catrin Finkenauer
- Department of Interdisciplinary Social Science, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht 3584 CH, The Netherlands.
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam 1081 BT, The Netherlands.
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18
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Wetherall K, Robb KA, O'Connor RC. Social rank theory of depression: A systematic review of self-perceptions of social rank and their relationship with depressive symptoms and suicide risk. J Affect Disord 2019; 246:300-319. [PMID: 30594043 DOI: 10.1016/j.jad.2018.12.045] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 11/08/2018] [Accepted: 12/16/2018] [Indexed: 02/01/2023]
Abstract
BACKGROUND Depression can be debilitating, as well as a risk factor for self-harm and suicide. Social rank theory (SRT) suggests depression stems from feelings of defeat and entrapment that ensue from experiencing oneself to be of lower rank than others. This study aims to review the literature investigating the relationship between self-perceptions of social rank and depressive symptoms or suicidal ideation/behaviour. METHODS A keyword search of three psychological and medical databases was completed (Psychinfo, Medline, Web of Knowledge). Studies were quality assessed using established criteria. RESULTS An initial 1290 records were identified. After application of inclusion and exclusion criteria, 70 remained measuring depressive symptoms (n = 68), self-harm (n = 3) and suicidal ideation (n = 3). The main measures assessing social rank were the social comparison scale (SCS; n = 32) and subjective social status (SSS, n = 32), with six additional papers including another measure of social rank. In univariate analyses, as perceptions of social rank decreased, depressive symptoms (and suicidal ideation/self-harm) increased. Multivariate analyses indicated that social rank may act as a psychosocial mechanism to explain the relationship between social factors (in particular socio-economic status) and depressive symptoms. Additionally, psychological variables, such as rumination or self-esteem, may mediate or moderate the relationship between social rank and depressive or suicidal symptoms. LIMITATIONS Study quality was variable and 89% of studies were cross-sectional. CONCLUSIONS Although more prospective research is required, this review highlights the importance of understanding an individual's perception of their social position compared to others as it may lead to an enhanced understanding of the aetiology of depressive disorders.
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Affiliation(s)
- Karen Wetherall
- Suicidal Behaviour Research Laboratory, Institute of Health and Wellbeing, University of Glasgow, 1055 Great Western Road, Glasgow G12 0XH, UK.
| | - Kathryn A Robb
- Institute of Health and Wellbeing, University of Glasgow, 1055 Great Western Road, Glasgow G12 0XH, UK
| | - Rory C O'Connor
- Suicidal Behaviour Research Laboratory, Institute of Health and Wellbeing, University of Glasgow, 1055 Great Western Road, Glasgow G12 0XH, UK
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19
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Chiao C, Chen YY. Is caregiving by baby boomer women related to the presence of depressive symptoms? Evidence from eight national surveys. BMC WOMENS HEALTH 2018; 18:203. [PMID: 30567543 PMCID: PMC6299930 DOI: 10.1186/s12905-018-0696-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 11/30/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND A common hypothesis is that caregiving is deleterious to women's mental health. International studies continue to emphasize the importance of mental health issues for women. Yet only a few researchers have used population-based surveys to explore the association between caregiving and depressive symptomatology in the context of the community, and even less is known about this aspect of Baby Boomer women in a global context. METHODS The present study uses eight international surveys covering nineteen nations (N = 15,100) and uses multilevel logistic models to examine possible linkages between caregiving and the likelihood of depressive symptoms among Baby Boomer women, when taking individual-level and country-level social factors into consideration. RESULTS The various analyses found a significant variation in the likelihood of depressive symptoms among these Boomer women across the nations investigated and across both individual-level and country-level characteristics. The significant association of caregiving by women and the likelihood of depressive symptoms is related to their social status in some nations (OR = 1.30; p < 0.001). Boomer women living in countries with high rates of female participation in managerial/professional work (OR = 1.04; p < 0.05) and living in countries where women are often in vulnerable employment (OR = 1.01; p < 0.05) are at greater risk of depressive symptomatology. CONCLUSIONS These findings demonstrate that the depressive consequences of caregiving by women are, to some degree, contingent upon social context and structure. Policies aimed at promoting mental health among female Baby Boomers should therefore be context specific.
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Affiliation(s)
- Chi Chiao
- Institute of Health and Welfare Policy and Institute of Public Health, School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Li-Nong St., 112, Taipei, Taiwan, Republic of China.
| | - Yun-Yu Chen
- Institute of Health and Welfare Policy and Institute of Public Health, School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Li-Nong St., 112, Taipei, Taiwan, Republic of China
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20
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Hoebel J, Lampert T. Subjective social status and health: Multidisciplinary explanations and methodological challenges. J Health Psychol 2018; 25:173-185. [DOI: 10.1177/1359105318800804] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Since the early 2000s, evidence has been accumulating that subjective social status – a person’s sense of their own position on the social ladder – affects health above and beyond objective socioeconomic status. To date, however, little is known about how these distinct health effects of subjective social status can be explained. This article narratively reviews different explanatory approaches and key methodological challenges, backed up by empirical findings and supplemented by the authors’ own reflections. Both social–psychological and psychoneurobiological explanations can make a theoretically plausible contribution to explaining the subjective social status–health relationship. Experimental and panel designs appear promising for addressing important methodological challenges in this strand of research.
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21
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Zang E, Bardo AR. Objective and Subjective Socioeconomic Status, Their Discrepancy, and Health: Evidence from East Asia. SOCIAL INDICATORS RESEARCH 2018; 143:765-794. [PMID: 32982014 PMCID: PMC7517660 DOI: 10.1007/s11205-018-1991-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/30/2018] [Indexed: 06/11/2023]
Abstract
Socioeconomic status (SES) is largely understood to be a fundamental determinant of health. Recently, subjective socioeconomic status (SSS) has emerged as a potentially important predictor of health above and beyond traditional (i.e., objective) SES indicators (OSS). The current study adds to this emerging body of research by examining the potentially important role of status discrepancies for health outcomes. We used nationally representative data from three East Asian countries (China, Japan, and South Korea) (2010 East Asian Social Survey) and a non-linear statistical technique (i.e., diagonal mobility model) to simultaneously model the independent contributions of OSS and SSS and their discrepancy for three health outcomes. Findings showed that SSS does, in fact, explain additional variation in health net of OSS in most cases, and status discrepancy is not associated with any of the three health outcomes. While status discrepancy was not found to be a driving factor in determining the predictive power of SSS net of OSS (at least in East Asia), the present study adds robustness to the accumulating evidence that challenges the social inequality hypothesis and provides a basis from which future research can build and contribute further to the understanding surrounding socioeconomic status and health outcomes.
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Affiliation(s)
- Emma Zang
- Sanford School of Public Policy, Duke University, Durham, USA
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22
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Bacak V. Measuring inequalities in health from survey data using self-assessed social class. J Public Health (Oxf) 2018; 40:183-190. [PMID: 28369582 DOI: 10.1093/pubmed/fdx036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Indexed: 11/12/2022] Open
Abstract
Background Asking participants to assess their social class may be an efficient approach to examining inequalities in heath from survey data. The present study investigated this possibility empirically by testing whether subjective class identification is related to overall health. Methods I used pooled cross-sectional data from the 2012 and the 2014 General Social Survey, a nationally representative survey carried out among adults in the United States. The association between health and class was estimated separately by gender, race and age. Results The association follows a gradient pattern where health deteriorates with lower class position even after controlling for indicators typically used in research that examines class differences in health-educational attainment, family income and occupational prestige. The results largely hold when the data are stratified by gender, race and age. Conclusions These findings demonstrate the empirical value of subjective class identification for assessing social inequalities in health from survey data.
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Affiliation(s)
- Valerio Bacak
- School of Criminal Justice, Rutgers University, 123 Washington Street, Newark, NJ 07102-3094, USA
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23
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Fredriksen-Goldsen KI, Bryan AEB, Jen S, Goldsen J, Kim HJ, Muraco A. The Unfolding of LGBT Lives: Key Events Associated With Health and Well-being in Later Life. THE GERONTOLOGIST 2017; 57:S15-S29. [PMID: 28087792 DOI: 10.1093/geront/gnw185] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 12/22/2016] [Indexed: 01/06/2023] Open
Abstract
PURPOSE OF THE STUDY Life events are associated with the health and well-being of older adults. Using the Health Equity Promotion Model, this article explores historical and environmental context as it frames life experiences and adaptation of lesbian, gay, bisexual, and transgender (LGBT) older adults. DESIGN AND METHODS This was the largest study to date of LGBT older adults to identify life events related to identity development, work, and kin relationships and their associations with health and quality of life (QOL). Using latent profile analysis (LPA), clusters of life events were identified and associations between life event clusters were tested. RESULTS On average, LGBT older adults first disclosed their identities in their 20s; many experienced job-related discrimination. More had been in opposite-sex marriage than in same-sex marriage. Four clusters emerged: "Retired Survivors" were the oldest and one of the most prevalent groups; "Midlife Bloomers" first disclosed their LGBT identities in mid-40s, on average; "Beleaguered At-Risk" had high rates of job-related discrimination and few social resources; and "Visibly Resourced" had a high degree of identity visibility and were socially and economically advantaged. Clusters differed significantly in mental and physical health and QOL, with the Visibly Resourced faring best and Beleaguered At-Risk faring worst on most indicators; Retired Survivors and Midlife Bloomers showed similar health and QOL. IMPLICATIONS Historical and environmental contexts frame normative and non-normative life events. Future research will benefit from the use of longitudinal data and an assessment of timing and sequencing of key life events in the lives of LGBT older adults.
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Affiliation(s)
| | | | - Sarah Jen
- School of Social Work, University of Washington, Seattle
| | - Jayn Goldsen
- School of Social Work, University of Washington, Seattle
| | - Hyun-Jun Kim
- School of Social Work, University of Washington, Seattle
| | - Anna Muraco
- Department of Sociology, Loyola Marymount University, Los Angeles, California
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Goldsen J, Bryan AEB, Kim HJ, Muraco A, Jen S, Fredriksen-Goldsen KI. Who Says I Do: The Changing Context of Marriage and Health and Quality of Life for LGBT Older Adults. THE GERONTOLOGIST 2017; 57:S50-S62. [PMID: 28087795 DOI: 10.1093/geront/gnw174] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 11/04/2016] [Indexed: 11/14/2022] Open
Abstract
PURPOSE OF THE STUDY Until recently, lesbian, gay, bisexual, and transgender (LGBT) adults were excluded from full participation in civil marriage. The purpose of this study is to examine how legal marriage and relationship status are associated with health-promoting and at-risk factors, health, and quality of life of LGBT adults aged 50 and older. DESIGN AND METHODS We utilized weighted survey data from Aging with Pride: National Health, Aging, and Sexuality/Gender Study (NHAS) participants who resided in states with legalized same-sex marriage in 2014 (N = 1,821). Multinomial logistic regression was conducted to examine differences by relationship status (legally married, unmarried partnered, single) in economic and social resources; LGBT contextual and identity factors; health; and quality of life. RESULTS We found 24% were legally married, and 26% unmarried partnered; one-half were single. Those legally married reported better quality of life and more economic and social resources than unmarried partnered; physical health indicators were similar between legally married and unmarried partnered. Those single reported poorer health and fewer resources than legally married and unmarried partnered. Among women, being legally married was associated with more LGBT microaggressions. IMPLICATIONS LGBT older adults, and practitioners serving them, should become educated about how legal same-sex marriage interfaces with the context of LGBT older adults' lives, and policies and protections related to age and sexual and gender identity. Longitudinal research is needed to understand factors contributing to decisions to marry, including short- and long-term economic, social, and health outcomes associated with legal marriage among LGBT older adults.
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Affiliation(s)
- Jayn Goldsen
- School of Social Work, University of Washington, Seattle.
| | | | - Hyun-Jun Kim
- School of Social Work, University of Washington, Seattle
| | - Anna Muraco
- Department of Sociology, Loyola Marymount University, Los Angeles, CA
| | - Sarah Jen
- School of Social Work, University of Washington, Seattle
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25
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Weinstein G. Childhood conditions and current physical performance among non-institutionalized individuals aged 50+ in Israel. Eur J Ageing 2017; 13:335-347. [PMID: 28190995 DOI: 10.1007/s10433-016-0380-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Adverse socioeconomic conditions in childhood have been previously linked with high risk of various health conditions. However, the association with future physical function has been less studied. Hand grip strength and chair-rising time are objective measures of physical capability indicating current and future health outcomes. The aim of this study was to test the hypothesis that perceived socio-economic status in childhood is related to current measures of physical function, among Israeli participants of the Survey of Health, Ageing and Retirement in Europe project. The study included 2300 participants aged 50 years or older (mean age 68 ± 10; 56 % women). Generalized linear regression models were used to examine the associations of childhood wealth and number of books in residence with grip strength and time to complete five rises from a chair. Logistic regression models were used to assess the relationships between the early life conditions and the ability to perform the physical tests. Adjustment was made for current income or household wealth, and for demographic, anthropometric, health, and life-style measures. Being wealthy and having a large number of books at home in childhood was associated with a stronger hand grip and a better chair-rise test performance. These associations were more robust in women compared to men, and persisted after adjustment for potential covariates. In addition, childhood wealth and number of books were associated with lower risk of being unable to perform the tests. Thus, early-life programming may contribute to physical function indicators in mid- and late-life.
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Affiliation(s)
- Galit Weinstein
- School of Public Health, University of Haifa, 199 Aba Khoushy Ave., Mount Carmel, Haifa, Israel
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26
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Social identity, perceived urban neighborhood quality, and physical inactivity: A comparison study of China, Taiwan, and South Korea. Health Place 2016; 41:1-10. [PMID: 27372259 DOI: 10.1016/j.healthplace.2016.06.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 06/04/2016] [Accepted: 06/07/2016] [Indexed: 02/08/2023]
Abstract
UNLABELLED Asian countries are currently witnessing unprecedented increase in physical inactivity and subsequent negative health outcomes; however, few cross-country studies documenting this trend exist. This paper presents the findings of a nationally representative sample, based on the East Asian Social Survey in 2011. The study sought to examine the association of social identity factors, such as objective socio-economic position, perceived social status and neighborhood quality with physical inactivity, while controlling for psychosocial and physical health. A sample of 5222 adults living in urban areas across China, Taiwan, and South Korea were surveyed. METHODS Multivariate nested logistic regressions were constructed. RESULTS Perceived social status was positively associated with physical activity. Gender difference in physical activity was significant, and this difference widened as educational levels increased. Class division in physical activity was also found. Perceived physical and social features of neighborhood such as suitability for walking and jogging, air quality, and help from neighbors were to different degrees associated with physical inactivity. CONCLUSION Gender, marital status, education and perceived social status were common factors associated with physical inactivity in East Asian countries. Perceived urban neighborhood quality is particularly important for Chinese people to stay physically active. Cultural-behavioral norms for physical activity associated with gender and social status call for more studies on cultural perspective for health behaviors in cross-cultural contexts.
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27
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Chiao C, Weng LJ. Mid-life socioeconomic status, depressive symptomatology and general cognitive status among older adults: inter-relationships and temporal effects. BMC Geriatr 2016; 16:88. [PMID: 27099153 PMCID: PMC4839082 DOI: 10.1186/s12877-016-0257-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 04/13/2016] [Indexed: 11/11/2022] Open
Abstract
Background Few longitudinal studies have analyzed how socioeconomic status (SES) influences both depressive and cognitive development over an individual’s life course. This study investigates the change trajectories of both depressive symptomatology and general cognitive status, as well as their associations over time, focusing on the effects of mid-life SES. Methods Data were obtained from the Taiwan Longitudinal Study on Aging (1993–2007), a nationally representative cohort study of older adults in Taiwan. The short form of the Center of Epidemiological Studies-Depression (CES-D) scale that measures depressive symptomatology in two domains (negative affect and lack of positive affect) was used. General cognitive status was assessed using the brief Short Portable Mental Status Questionnaire scale. Assessments of the subjects’ mid-life SES included measurement of the participant’s education and occupation. Analyses were conducted by the parallel latent growth curve modeling. Results The participants’ initial levels of depressive symptomatology and general cognitive status were significantly and negatively correlated; furthermore, any changes in these two outcomes were also correlated over time. The initial assessment of general cognitive status significantly contributed to any advancement towards more severe depressive symptomatology over time, particularly when this occurred in a negative manner. Furthermore, a mid-life SES advantage resulted in a significant reduction in late-life depressive symptomatology and also produced a slower decline in general cognitive status during later life. In contrast, lower mid-life SES exacerbated depressive symptomatology during old age, both at the initial assessment and in terms of the change over time. In addition, female gender was significantly associated with lower general cognitive status and more severe depressive symptomatology in negative affect. Conclusions These findings suggest a complex and longitudinal association between depressive symptomatology and general cognitive status in later life and this complicated relationship seems to be affected by mid-life SES over time.
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Affiliation(s)
- Chi Chiao
- Insitute of Health and Welfare Policy, Research Center for Health and Welfare Policy, College of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C.
| | - Li-Jen Weng
- Department of Psychology, College of Science, National Taiwan University, Taipei, Taiwan, R.O.C
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28
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Relative deprivation and risk factors for obesity in Canadian adolescents. Soc Sci Med 2016; 152:111-8. [PMID: 26851410 PMCID: PMC4774475 DOI: 10.1016/j.socscimed.2016.01.039] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 01/20/2016] [Accepted: 01/24/2016] [Indexed: 12/20/2022]
Abstract
Research on socioeconomic differences in overweight and obesity and on the ecological association between income inequality and obesity prevalence suggests that relative deprivation may contribute to lifestyle risk factors for obesity independently of absolute affluence. We tested this hypothesis using data on 25,980 adolescents (11-15 years) in the 2010 Canadian Health Behaviour in School-aged Children (HBSC) study. The Yitzhaki index of relative deprivation was applied to the HBSC Family Affluence Scale, an index of common material assets, with more affluent schoolmates representing the comparative reference group. Regression analysis tested the associations between relative deprivation and four obesity risk factors (skipping breakfasts, physical activity, and healthful and unhealthful food choices) plus dietary restraint. Relative deprivation uniquely related to skipping breakfasts, less physical activity, fewer healthful food choices (e.g., fruits, vegetables, whole grain breads), and a lower likelihood of dieting to lose weight. Consistent with Runciman's (1966) theory of relative deprivation and with psychosocial interpretations of the health consequences of income inequality, the results indicate that having mostly better off schoolmates can contribute to poorer health behaviours independently of school-level affluence and subjective social status. We discuss the implications of these findings for understanding the social origins of obesity and targeting health interventions.
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Präg P, Mills MC, Wittek R. Subjective socioeconomic status and health in cross-national comparison. Soc Sci Med 2016; 149:84-92. [DOI: 10.1016/j.socscimed.2015.11.044] [Citation(s) in RCA: 99] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2015] [Revised: 11/23/2015] [Accepted: 11/25/2015] [Indexed: 11/26/2022]
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Eifert EK, Wideman L, Oberlin DJ, Labban J. The relationship between physical activity and perceived health status in older women: findings from the Woman's College Alumni Study. J Women Aging 2015; 26:305-18. [PMID: 25133943 DOI: 10.1080/08952841.2014.906878] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Using data collected from the Woman's College (WC) Alumni Study, the purpose of this study was to determine whether perceived health status is related to physical activity in older women. A multiple linear regression analysis was conducted to examine the relationship between amounts of physical activity and self-reported health status. The results of the current study reveal that the level of physical activity is significantly correlated with perceived health status. The findings of this study have implications for the assessment of older individuals' health and may lead to interventions that are tailored to increase physical activity among older women.
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Affiliation(s)
- Elise K Eifert
- a Department of Public Health Education , University of North Carolina at Greensboro , Greensboro , NC
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Nielsen F, Roos JM, Combs RM. Clues of subjective social status among young adults. SOCIAL SCIENCE RESEARCH 2015; 52:370-388. [PMID: 26004468 DOI: 10.1016/j.ssresearch.2015.02.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Revised: 01/14/2015] [Accepted: 02/17/2015] [Indexed: 06/04/2023]
Abstract
We investigate determinants of subjective social status (SSS) as measured by respondents placing themselves on a ten-rung ladder from least to most "money", "education" and "respected job", in a large sample of young adults. The most potent clues of SSS are proximate in the life course, reflecting educational attainment and current socioeconomic and job situation, rather than distal characteristics such as family background, although relatively distal High school GPA has a lingering effect. Additional analyses reveal that College selectivity has a substantial impact on SSS, net of other variables in the model; Currently married does not significantly contribute to SSS, but contrary to some expectations Number of children significantly lowers SSS. We find no evidence of greater "status borrowing" by women as associations of SSS with shared household characteristics (Household income, Household assets, Home ownership) do not differ by gender. Our findings for these young adults support the conclusion of earlier research that SSS reflects a "cognitive averaging" of standard dimensions of socioeconomic status.
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Affiliation(s)
- François Nielsen
- University of North Carolina, Chapel Hill - Department of Sociology, Chapel Hill, NC 27599, USA.
| | - J Micah Roos
- University of California, Berkeley - Graduate School of Education, Berkeley, CA 94720, USA; Oklahoma State University, Department of Sociology, Stillwater, OK 74074, USA
| | - R M Combs
- University of North Carolina, Chapel Hill - School of Information and Library Science, Chapel Hill, NC 27599, USA
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Abstract
Both objective and, more recently, subjective measures of low social status have been linked to poor health outcomes. It is unclear, however, through which precise physiological mechanisms such standing may influence health, although it has been proposed that those of lower status may have biomarker profiles that are more dysregulated (and hence pose a greater risk for poorer health). The main objective of this study was to investigate whether lower subjective social standing is associated with riskier neuroendocrine biomarker profiles. Data were from the Social Environment and Biomarkers of Aging Study (SEBAS), a nationally representative survey of Taiwanese men and women (ages 54-91) conducted in Taiwan in 2000. Five neuroendocrine markers (cortisol, dehydroepiandrosterone sulphate (DHEAS), adrenaline, noradrenaline and dopamine) were analysed both separately and collectively in an index termed neuroendocrine allostatic load (NAL) in relation to status - both self-reported and as measured through objective socioeconomic status (SES) indicators. For the biomarker DHEAS, some connection was found between its levels and the measures of status, but for the other markers and the NAL index almost no connection was found. The overall negative finding of this paper would be further supported with more and different measures of neuroendocrine system function and a reordering of the subjective social status questions in the survey such that the one probing about status in the community (that has no prompt) was asked before the one probing about status in all of Taiwan (which has a SES prompt).
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Honjo K, Kawakami N, Tsuchiya M, Sakurai K. Association of subjective and objective socioeconomic status with subjective mental health and mental disorders among Japanese men and women. Int J Behav Med 2014; 21:421-9. [PMID: 23666845 DOI: 10.1007/s12529-013-9309-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND An inverse association between socioeconomic status (SES) and mental health has been previously well reported, but the evidence is limited in Asian populations. PURPOSE We therefore investigated the association of SES and subjective mental health and prevalence of any mental disorders in the general population of Japan. METHOD We used data from the World Mental Health Japan Survey of 1,496 randomly selected people aged 20 years and older in Japan. Information on education level and household income were used as objective SES indicators, and subjective social status (SSS) was measured by responses to a question regarding social position. We calculated odds ratios of SES indicators for poor subjective mental health and 12-month prevalence of any mental disorders. RESULTS The adjusted odds ratio (OR) (95 % confidence interval (CI)) of respondents who rated themselves as lower than middle status in the country (low SSS group) for poor subjective mental health was 2.24 (95 % CI: 1.41, 3.57) with reference to those who rated themselves as higher than middle status (high SSS group). Similarly, inverse associations of education level and household income with poor subjective mental health were identified. A J-shaped association was confirmed between SSS and 12-month prevalence of any mental disorders. The adjusted OR (95 % CI) of SSS for any mental diseases was 0.53 (95 % CI: 0.32, 0.86) for the middle SSS group and 1.61 (95 % CI: 0.96, 2.72) for the low SSS group, compared with the high SSS group. Those associations were not attenuated when objective SES indicators were adjusted. CONCLUSION We found inversely linear associations between subjective and objective SES and poor subjective mental health among Japanese men and women. SSS was not significantly associated with 12-month prevalence of any mental disorders. Substantial social inequalities in mental health were identified in Japan, which has been considered an egalitarian society with relatively few inequalities in health.
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Affiliation(s)
- Kaori Honjo
- Osaka University Global Collaboration Center, 2-7 Yamadaoka, Suita, Osaka, 565-0871, Japan,
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Quon EC, McGrath JJ. Community, family, and subjective socioeconomic status: Relative status and adolescent health. Health Psychol 2014; 34:591-601. [PMID: 25222085 DOI: 10.1037/hea0000135] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Relative socioeconomic status (SES) may be an important social determinant of health. The current study aimed to examine how relative SES, as measured by subjective SES, income inequality, and individual SES relative to others in the community, is associated with a wide range of adolescent health outcomes, after controlling for objective family SES. METHOD Adolescents (13-16 years; N = 2,199) from the Quebec Child and Adolescent Health and Social Survey were included. Socioeconomic measures included adolescents' subjective SES; parental education and household income; community education/employment, income, and poverty rate; and community income inequality. Health outcomes included self-rated health, mental health problems, dietary and exercise health behaviors, substance-related health behaviors, reported physical health, and biomarkers of health. Best-fitting multilevel regression models (participants nested within schools) were used to test associations. RESULTS Findings indicated that lower subjective SES was associated with poorer health outcomes. After accounting for family SES, lower community education/employment had an additional negative effect on health, while lower community income had a protective effect for certain health outcomes. There was less evidence for an independent effect of income inequality. CONCLUSIONS Findings highlight the importance of measures of relative SES that span across a number of levels and contexts, and provide further understanding into the socioeconomic gradient in adolescence.
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Affiliation(s)
| | - Jennifer J McGrath
- Pediatric Public Health Psychology Laboratory, Department of Psychology, Concordia University
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Chen YY, Chiao C, Ksobiech K. The effects of mid-life socioeconomic disadvantage and perceived social support on trajectories of subsequent depressive symptoms among older Taiwanese women. BMC Public Health 2014; 14:384. [PMID: 24751187 PMCID: PMC4040112 DOI: 10.1186/1471-2458-14-384] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Accepted: 04/04/2014] [Indexed: 11/10/2022] Open
Abstract
Background Scant research has taken a life-course perspective to explore the longitudinal impact of socioeconomic disadvantage and perceived social support on the psychological well-being of older women. We sought to explore whether socioeconomic disadvantage and perceived social support in mid-life are associated with subsequent depressive symptomatology among older Taiwanese women. Methods This study was based on data from the Taiwan Longitudinal Study on Aging conducted on a nationally representative sample (n = 1,073) of women aged 50 and above with a 12-year follow up. Mid-life socioeconomic disadvantage was assessed by socioeconomic status (SES) (i.e., educational attainment, major lifetime occupation in adulthood, and employment status) and economic strain. Perceived social support included three dimensions: listening, caring, and sick care. We used the short form of the Center of Epidemiological Studies-Depression (CES-D) scale that measures depressive symptomatology within two domains (negative affect and lack of positive affect). Growth curve models were employed to predict the relationships between mid-life socioeconomic disadvantage, perceived social support, and subsequent depressive trajectories, controlling for aging effects. Results Multivariate analyses demonstrated older women in a socioeconomic disadvantaged position are more likely to report higher initial levels of depressive symptoms in both domains; lack of formal education did not exacerbate depressive symptoms in the lack of positive affect domain over time. In addition, mid-life perceived positive social support in caring and sick care was associated with lower initial levels of depressive symptoms in both domains. Conclusions Our results suggest independent effects of mid-life socioeconomic disadvantage and perceived social support on subsequent depressive symptomatology among older Taiwanese women.
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Affiliation(s)
| | - Chi Chiao
- Institute of Health and Welfare Policy, Center for Health and Welfare Policy, School of Medicine, National Yang-Ming University, No, 155, Sec, 2, Li-Nong Street, 112 Taipei, Taiwan.
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Lee J, Divaris K. The ethical imperative of addressing oral health disparities: a unifying framework. J Dent Res 2014; 93:224-30. [PMID: 24189268 PMCID: PMC3929974 DOI: 10.1177/0022034513511821] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 09/18/2013] [Accepted: 10/12/2013] [Indexed: 12/11/2022] Open
Abstract
Health disparities are preventable differences in the burden of disease or opportunities to achieve optimal health that are experienced by socially disadvantaged population groups. Reducing health disparities has been identified as an ethical imperative by the World Health Organization's Commission on Social Determinants of Health and numerous other national and international bodies. Significant progress has been made over the past years in identifying vulnerable groups, and 'distal' factors including political, economic, social, and community characteristics are now considered pivotal. It is thus unsurprising that the remarkable advances in the science and practice of dentistry have not led to notable reductions in oral health disparities. In this review, we summarize recent work and emphasize the need for a solid theoretical framing to guide oral health disparities research. We provide a theoretical framework outlining pathways that operate across the continuum of oral health determinants during the lifecourse and highlight potential areas for intervention. Because oral health disparities emanate from the unequal distribution of social, political, economic, and environmental resources, tangible progress is likely to be realized only by a global movement and concerted efforts by all stakeholders, including policymakers, the civil society, and academic, professional, and scientific bodies.
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Affiliation(s)
- J.Y. Lee
- The University of North Carolina at Chapel Hill - Department of Pediatric Dentistry, 228 Brauer Hall, Chapel Hill, North Carolina 27599, USA
| | - K. Divaris
- The University of North Carolina at Chapel Hill - Department of Pediatric Dentistry, 228 Brauer Hall, Chapel Hill, North Carolina 27599, USA
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Karraker A. "Feeling poor": perceived economic position and environmental mastery among older Americans. J Aging Health 2014; 26:474-94. [PMID: 24567367 DOI: 10.1177/0898264314522296] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study examines the relationship between perceived economic position (PEP), objective socioeconomic status, and environmental mastery among older Americans. METHOD Using data from the National Social Life, Health, and Aging Project (NSHAP), I examine (a) whether PEP is associated with environmental mastery even after accounting for objective economic status and (b) whether the relationship between PEP and mastery varies by reference group (peers, Americans). RESULTS High PEP is associated with higher mastery while low PEP is associated with lower mastery, even after controlling for objective economic status. In general, the relationship between PEP and mastery does not vary whether PEP relative to peers or PEP relative to American families is examined. DISCUSSION These analyses provide insights into the important role of social comparisons in the connection between socioeconomic status and psychological well-being in the later life course.
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Quon EC, McGrath JJ. Subjective socioeconomic status and adolescent health: a meta-analysis. Health Psychol 2013; 33:433-47. [PMID: 24245837 DOI: 10.1037/a0033716] [Citation(s) in RCA: 209] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To comprehensively and quantitatively examine the association between subjective socioeconomic status (SES) and health outcomes during adolescence. METHODS Forty-four studies met criteria for inclusion in the meta-analysis. Information on study quality, demographics, subjective SES, health outcomes, and covariates were extracted from each study. Fisher's Z was selected as the common effect size metric across studies. Random-effect meta-analytic models were employed and fail-safe numbers were generated to address publication bias. RESULTS Overall, subjective SES was associated with health during adolescence (Fisher's Z = .10). The magnitude of the effect varied by type of health outcome, with larger effects observed for mental health outcomes, self-rated health, and general health symptoms; and nonsignificant effects observed for biomarkers of health and substance-use-related health behaviors. Of the measures of subjective SES employed in the reviewed studies, perception of financial constraints, was most strongly associated with adolescent health outcomes. Analysis of covariates indicated that inclusion of objective SES covariates did not affect the association between subjective SES and health. CONCLUSIONS This meta-analysis has implications for the measurement of subjective SES in adolescents, for the conceptualization of subjective and objective SES, and for the pathways between SES and health in adolescents.
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Ricks TN, Harrison T. Disability and health: exploring the disablement experience of young adult African Americans. Disabil Rehabil 2013; 36:479-86. [PMID: 23745770 PMCID: PMC3773289 DOI: 10.3109/09638288.2013.798362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE The objective of this study was to examine disablement as experienced by young adult African American men and women with permanent mobility impairment. METHOD This study included a sample of 5 male and 5 female participants ranging in age from 22 to 39. An exploratory descriptive design and qualitative methods, including interviews and fieldnotes, were used. Interview data was analyzed using the process of inductive qualitative content analysis. RESULTS Basic desires for independence, shared intimacy, and psychological and physical health were not diminished by physical limitations. The disablement experience of this group is reflected in the themes of "Cumulative Losses" and "Sustained Desires". The findings of this study describe the high level of motivation that young adult African American men and women with disabilities have to improve levels of health and well-being within the context of their impairments. CONCLUSION This study provides a better understanding of the contextual factors and experiences that may contribute to the development of further disability and subsequent health-related problems over time. Increased knowledge of the disablement experience of these young men and women may assist health care entities and social service providers in improving health care and rehabilitation efforts targeting this group. Implications for Rehabilitation Disablement among African American Young Adults This study's findings describe the high level of motivation that young adult African American men and women with disabilities have to improve levels of health and well-being. The two primary themes, "Cumulative Losses" and "Sustained Desires", suggest that despite a number of significant losses, several innate desires remained intact in the context of impairment. Understanding the disablement experience of young African Americans may assist health care entities and social service providers in improving health care targeting this group.
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Affiliation(s)
- Tiffany N. Ricks
- The University of Texas at Austin 1700 Red River Street Austin, TX 78701 Phone: 512-431-5174
| | - Tracie Harrison
- The University of Texas at Austin 1700 Red River Street Austin, TX 78701 Phone: 512-471-9085
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Nobles J, Weintraub MR, Adler NE. Subjective socioeconomic status and health: relationships reconsidered. Soc Sci Med 2013; 82:58-66. [PMID: 23453318 DOI: 10.1016/j.socscimed.2013.01.021] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Revised: 12/13/2012] [Accepted: 01/20/2013] [Indexed: 11/25/2022]
Abstract
Subjective status, an individual's perception of her socioeconomic standing, is a robust predictor of physical health in many societies. To date, competing interpretations of this correlation remain unresolved. Using longitudinal data on 8430 older adults from the 2000 and 2007 waves of the Indonesia Family Life Survey, we test these oft-cited links. As in other settings, perceived status is a robust predictor of self-rated health, and also of physical functioning and nurse-assessed general health. These relationships persist in the presence of controls for unobserved traits, such as difficult-to-measure aspects of family background and persistent aspects of personality. However, we find evidence that these links likely represent bi-directional effects. Declines in health that accompany aging are robust predictors of declines in perceived socioeconomic status, net of observed changes to the economic profile of respondents. The results thus underscore the social value afforded good health status.
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Affiliation(s)
- Jenna Nobles
- Sociology, University of Wisconsin, Madison, 4456 Sewell Social Sciences, 1180 Observatory Drive, Madison, WI 53706, USA.
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Halleröd B, Gustafsson JE. A longitudinal analysis of the relationship between changes in socio-economic status and changes in health. Soc Sci Med 2010; 72:116-23. [PMID: 21074920 DOI: 10.1016/j.socscimed.2010.09.036] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2009] [Revised: 08/31/2010] [Accepted: 09/28/2010] [Indexed: 10/18/2022]
Abstract
In this paper we contribute to discussion on the relationship between different aspects of socio-economic status (SES) and health. Separating different aspects of SES facilitates the specification of a structural relationship between SES indicators and morbidity. Longitudinal data and the utilization of growth curve modelling enable an empirical analysis of the direct relationship between changes over time in SES indicators and changes in morbidity. Our empirical analysis is based on panel data (N = 2976) derived from the annual Swedish Survey of Living Conditions. The panel, which consists of respondents that at the first panel wave were between 31 and 47 years old, is followed for 16 years, starting in 1979. Data are gathered at three points of time. A growth curve model is set up using structural equation modelling. The structural relationship and changes over time are simultaneously estimated. It is shown that in relation to health occupational position is crucial, canalising the effects of class of origin and education. More prestigious jobs are related to initially good health and to a less rapid deterioration in health. At the same time initial health affects occupational mobility, confirming a health selection into less prestigious jobs. It is also shown that change of occupation and income are related to change in health. The analysis confirms a strong relationship between SES and morbidity and shows that initial SES affects later changes in morbidity, i.e., a causal relationship exists between SES and morbidity. But, the analysis also demonstrates the existence of selection effects, meaning that initial morbidity causes less favourable changes in SES. It is finally revealed that changes in occupational prestige and income changes co-vary with changes in morbidity. Hence, the analysis provides basic information necessary to make any assumption about causality and selection in relation to SES and health.
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Affiliation(s)
- Björn Halleröd
- Department of Sociology, University of Gothenburg, Box 720, 405 30 Gothenburg, Sweden.
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Bradshaw M, Ellison CG. Financial hardship and psychological distress: exploring the buffering effects of religion. Soc Sci Med 2010; 71:196-204. [PMID: 20556889 DOI: 10.1016/j.socscimed.2010.03.015] [Citation(s) in RCA: 108] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Despite ample precedent in theology and social theory, few studies have systematically examined the role of religion in mitigating the harmful effects of socioeconomic deprivation on mental health. The present study outlines several arguments linking objective and subjective measures of financial hardship, as well as multiple aspects of religious life, with psychological distress. Relevant hypotheses are then tested using data on adults aged 18-59 from the 1998 USNORC General Social Survey. Findings confirm that both types of financial hardship are positively associated with distress, and that several different aspects of religious life buffer against these deleterious influences. Specifically, religious attendance and the belief in an afterlife moderate the deleterious effects of financial hardship on both objective and subjective financial hardship, while meditation serves this function only for objective hardship. No interactive relationships were found between frequency of prayer and financial hardship. A number of implications, study limitations, and directions for future research are identified.
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Affiliation(s)
- Matt Bradshaw
- University of North Carolina, Carolina Population Center, University Square, CB# 8120 123 West Franklin Street, Chapel Hill, NC 27516, USA.
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