Compared to whom? Subjective social status, self-rated health, and referent group sensitivity in a diverse US sample

Abstract

Emerging research has revealed that subjective social status (SSS), or how people perceive their position in the social hierarchy, is significantly associated with multiple health outcomes. Yet few studies have examined how this association is affected by the person or group to whom respondents are comparing themselves. While previous studies have used distal referent groups when assessing SSS, scholars have suggested that individuals may prefer to make comparisons to those who share similar characteristics to themselves. Overall, there has been little empirical analysis assessing the health impact of comparing oneself to one referent group over another. Using a diverse, national U.S. sample (n=3,644), this study explores whether the relationship between SSS and self-rated health is sensitive to the referent used for social comparison. Data are from respondents who completed the Styles mail surveys and who have assessed their SSS against four referents: others in American society, others of the same race or ethnicity, neighbors, and parents at the same age. Self-rated health was the dependent variable, while we controlled for household income, education, home ownership, race/ethnicity, and other covariates. In logistic regression models, SSS using each of the four referents was significantly associated with self-rated health, but the model using the referent of others in American society had the strongest association with self-rated health and was the most parsimonious. Findings validate previous studies which typically have used a more distal referent such as others in American society in exploring the SSS-health relationship. However, future work should explore whether this referent is salient to diverse population groups when making social comparisons. Researchers may also want to consider using SSS as an additional status measure since it may capture more subtle differences in the status hierarchy than traditional economic measures.

Health inequalities among rural and urban population of Eastern Poland in the context of sustainable development

“…The study of differences in health between European countries proved that in all of the analysed European countries, including Poland, selfassessment of health increases with income. This is similar to the studies of L. S. Wolff et al [38] concerning the USA. According to these studies, self-rated health was dependent on household income, education, home ownership, and race/ethnicity.…”

“…The results of the presented study concerning Eastern Poland generally correspond to the results of studies from other countries (Norway, Hungary, South Africa, USA and Netherlands), and indicate a relationship between the socioeconomic position, and self-assessment of health status [35,36,37,38,39,7]. Research conducted by K. M. Olsen and S. A. Dahl [13] concerning the differences in the health of residents of 21 European countries showed that the health status of the population in the analysed countries depended on a variety of political, socio-economic and behavioural characteristics.…”

“…Financial factors also affect respondents' choices of treatment in the event of health problems. The level of education and professional status of the population in Eastern Poland, as in studies by other authors [14,38,40], did not play such a significant role in the differentiation of the level of health of the population, as the income level and age. K. Stronks et al proved that the low income in The Netherlands had definite health effects through relative deprivation; there was an indirect link between deprivation and health problems involving psychological and behavioural factors [7].…”

Subjective socioeconomic status and health in cross-national comparison

“…While many of the studies focused on select populations, such as pregnant women (Reitzel et al, 2007), adolescents (Quon and McGrath, 2014), older adults (Garbarski, 2010), or civil service workers (Singh-Manoux et al, 2003, relatively few used representative samples of the general population (Nobles et al, 2013;Sakurai et al, 2010;Wolff et al, 2010). Understanding the interplay of objective and subjective SES, however, requires samples that are free from selection bias, including all SES groups of a population, as associations found in restricted samples might misrepresent those apparent in the general population.…”

“…The relationship between objective and subjective socioeconomic status (SES) is a classic topic within sociology (Evans and Kelley, 2004;Lindemann and Saar, 2014;Marx, 1976) that has recently resurfaced in public health research (Adler, 2013;Nobles et al, 2013;Singh-Manoux et al, 2005;Wolff et al, 2010). While sociological research on the issue long focused on class conflict and the potential for social revolution, public health research has discovered a robust association between subjective SES and a diverse range of health outcomes, usually over and above the influence of objective measures of social status.…”