Status incongruence has been related to poor health and all-cause mortality, and could be a growing public health problem due to changes in the labour market in later decades. Shaming experiences have been suggested as playing a part in the aetiology. The aim here was to study the risk for shaming experiences, pessimism, anxiety, depressive feelings, and poor mental wellbeing (as measured by the GHQ) with a special focus on shame, in four social status categories: negatively and positively incongruent individuals, and low-status and high-status congruent individuals. Data comprised 14,854 working men and women from a regional sample of randomly selected respondents, 18-79 years of age. Logistic regression was used to study differences in risk for negative emotional outcomes. Results showed that the negative incongruent category persisted as the group most at risk for all negative emotional outcomes (OR 1.5-1.9; p < 0.05-<0.001). When testing the risk for poor mental wellbeing among the status categories with and without shaming experiences, ORs for all groups with shaming experiences were elevated. Among groups without shame, only the negative incongruent category remained at risk (OR 2.7; p < 0.05) after adjustment. Negative incongruent status is associated with adverse emotional outcomes, among them shame, which is a previously unappreciated aspect of status incongruence.

Objective Associations between subjective status and health are still relatively unexplored. This study aimed at testing whether subjective status is uniquely confounded by psychosocial factors compared to objective status, and what factors that may predict subjective status. Design A cross-sectional analysis of a population-based, random sample of 795 middle-aged men and women from the southeast of Sweden. Questionnaires included subjective status, objective measures of socioeconomic status, life satisfaction, and a battery of psychosocial factors. Associations were controlled for effects of age and sex. Results Both subjective status and occupation were significantly associated with self-rated health also after control for psychosocial factors. Stepwise regression showed that subjective status was significantly influenced by self-rated economy, education, life satisfaction, self-esteem, trust, perceived control, and mastery. Conclusion The association between subjective status and self-rated health does not seem to be uniquely confounded by psychosocial factors. Both resource-based measures and psychological dimensions seem to influence subjective status ratings. Comparative studies are required to study whether predictors of subjective status vary between countries with different socio-political profiles.The original publication is available at www.springerlink.com:Johanna Lundberg and Margareta Kristenson, Is Subjective Status Influenced by Psychosocial Factors?, 2008, Social Indicators Research, (89), 3, 375-390.http://dx.doi.org/10.1007/s11205-008-9238-3Copyright: Springer Science Business Mediahttp://www.springerlink.com

BackgroundThis cross-sectional study of two middle-aged community samples from Sweden and Russia examined the distribution of perceived control scores in the two populations, investigated differences in individual control items between the populations, and assessed the association between perceived control and self-rated health.MethodsThe samples consisted of men and women aged 45–69 years, randomly selected from national and local population registers in southeast Sweden (n = 1007) and in Novosibirsk, Russia (n = 9231). Data were collected by structured questionnaires and clinical measures at a visit to a clinic. The questionnaire covered socioeconomic and lifestyle factors, societal circumstances, and psychosocial measures. Self-rated health was assessed by standard single question with five possible answers, with a cut-off point at the top two alternatives.Results32.2 % of Swedish men and women reported good health, compared to 10.3 % of Russian men and women. Levels of perceived control were also significantly lower in Russia than in Sweden and varied by socio-demographic parameters in both populations. Sub-item analysis of the control questionnaire revealed substantial differences between the populations both in the perception of control over life and over health. Logistic regression analysis revealed that the odds ratios (OR) of poor self-rated health were significantly increased in men and women with low perceived control in both countries (OR between 2.61 and 4.26).ConclusionAlthough the cross-sectional design does not allow causal inference, these results support the view that perceived control influences health, and that it may mediate the link between socioeconomic hardship and health.

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We found a consistent pattern for outpatient visits related to musculoskeletal problems where people with low SES counted more visits and this was most prominent in groups of poor SRH. The results demonstrate the need to apply different morbidity measures when studying inequalities in healthcare utilisation.