Socioeconomic position over the life-course and subjective social status in relation to nutritional status and mental health among Guatemalan adults

Varghese, Jithin Sam; Waford, Rachel; DiGirolamo, Ann; Martorell, Reynaldo; Ramírez‐Zea, Manuel; Stein, Aryeh D.

doi:10.1016/j.ssmph.2021.100880

Cited by 8 publications

(10 citation statements)

References 59 publications

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“…This research extends previous investigation of subjective social status with outcomes in Guatemala by including two new settings and additionally considering life satisfaction, marital status, and whether they had children ( Varghese et al., 2021 ). Subjective wellbeing consists of three domains: evaluative wellbeing (life satisfaction), emotional wellbeing (experienced wellbeing) and eudaimonic wellbeing (e.g.…”

Section: Discussionsupporting

confidence: 51%

Subjective social status is associated with happiness but not weight status or psychological distress: An analysis of three prospective birth cohorts from low- and middle-income countries

Varghese

Waford

Adair

et al. 2022

Wellbeing, Space and Society

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Section: Discussionsupporting

confidence: 51%

Subjective social status is associated with happiness but not weight status or psychological distress: An analysis of three prospective birth cohorts from low- and middle-income countries

Varghese

Waford

Adair

et al. 2022

Wellbeing, Space and Society

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“…First, our study was conducted in a distinct population of people with lower SES in Lima, and therefore, our results may not be generalizable to a different population. However, it is reasonable to think that our findings may apply to other low- and middle-income countries where the socio-economic distributions are comparable [ 19 , 38 ]. Second, our findings may be subject to selection bias if the 26% of the TB patients, who were approached by our field staff but refused to participate, had different socio-economic statuses than those who were enrolled in the study.…”

Section: Discussionmentioning

confidence: 99%

“…Subjective SES has been shown to be independently associated with other objective indicators, to be a stronger predictor of health outcomes than objective measures, and to mediate the relationship between objective SES and health [ 14 , 18 – 21 ]. In addition, subjective SES has been shown to be associated with health outcomes, independently of objective SES [ 14 , 19 ]. Thus researchers have suggested that subjective SES reflects relevant or additional dimensions of SES that cannot be captured through objective measurements.…”

Section: Introductionmentioning

confidence: 99%

Subjective socioeconomic status: an alternative to objective socioeconomic status

Zhao

Huang

Mendoza

et al. 2023

BMC Med Res Methodol

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Background Subjective “ladder” measurements of socio-economic status (SES) are easy-to-administer tools that ask respondents to rate their own SES, allowing them to evaluate their own material resources and determine where it places them relative to their community. Here, we sought to compare the MacArthur Scale of Subjective Social status to the WAMI, an objective measure of SES that includes data on water and sanitation, asset ownership, education, and income. Methods Leveraging a study of 595 tuberculosis patients in Lima, Peru, we compared the MacArthur ladder score to the WAMI score using weighted Kappa scores and Spearman’s rank correlation coefficient. We identified outliers that fell outside the 95th percentile and assessed the durability of the inconsistencies between scores by re-testing a subset of participants. We then used Akaike information criterion (AIC) to compare the predictability of logistic regression models evaluating the association between the two SES scoring systems and history of asthma. Results The correlation coefficient between the MacArthur ladder and WAMI scores was 0.37 and the weighted Kappa was 0.26. The correlation coefficients differed by less than 0.04 and the Kappa ranged from 0.26 to 0.34, indicating fair agreement. When we replaced the initial MacArthur ladder scores with retest scores, the number of individuals with disagreements between the two scores decreased from 21 to 10 and the correlation coefficient and weighted Kappa both increased by at least 0.03. Lastly, we found that when we categorized WAMI and MacArthur ladder scores into three groups, both had a linear trend association with history of asthma with effect sizes and AICs that differed by less than 15% and 2 points, respectively. Conclusion Our findings demonstrated fair agreement between the MacArthur ladder and WAMI scores. The agreement between the two SES measurements increased when they were further categorized into 3–5 categories, the form in which SES is often used in epidemiologic studies. The MacArthur score also performed similarly to WAMI in predicting a socio-economically sensitive health outcome. Researchers should consider subjective SES tools as an alternative method for measuring SES, particularly in large health studies where data collection is a burden.

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“…(12)(13)(14)(15)(16)(17)(18) Subjective SES has been shown to be independently associated with other objective indicators, to be a stronger predictor of health outcomes than objective measures, and to mediate the relationship between objective SES and health. (14,(18)(19)(20)(21) Secondly, researchers have described self-reported SES as a comprehensive measure where individuals can judge which objective SES factors are the most important contributors to their subjective SES. (12) Third, the "averaging hypothesis" proposes that subjective SES is a more dynamic assessment since individuals can evaluate their past, current and future prospects within the context of their social and cultural environment.…”

Section: Introductionmentioning

confidence: 99%

Subjective socioeconomic status: an alternative to objective socioeconomic status

Zhao

Huang

Mendoza

et al. 2022

Preprint

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Background Subjective “ladder” measurements of socio-economic status (SES) are easy-to-administer tools that ask respondents to rate their own SES, allowing them to evaluate where they believe their material resources place them relative to their community. Here, we sought to compare a ladder score to a measure of SES that includes data on water and sanitation, asset ownership, education, and income (WAMI). Methods Leveraging an ongoing study of adult patients with tuberculosis in Lima, Peru, we compared results of the WAMI survey to the MacArthur Scale of Subjective Social Status. We assessed the relationship between WAMI and the ladder scores using Kappa scores and Spearman’s rank correlation coefficient. We used Akaike information criterion (AIC) to compare the predictability of logistic regression models that evaluated the association between SES and history of asthma. Results Among 595 participants who completed both questionnaires, the MacArthur ladder and WAMI scores were within two or less points (on a scale of 10 points) of each other for 84% of participants. The correlation coefficient was 0.34 (p < 0.001). Among 36 participants with a repeated ladder test, the 18 individuals who were selected for initially having dissimilar ladder and WAMI scores had a greater median decrease in their retested ladder scores (median 5, IQR: 1.25 to 6) compared to the 18 individuals who had similar scores (median 2, IQR: 0 to 3). When initial ladder scores were replaced with the repeated responses, the overall correlation coefficient increased to 0.40 (p < 0.001) and the variability in the difference between the ladder scores and WAMI decreased. Both SES scores were associated with history of asthma. Conclusion Our findings demonstrate that the MacArthur SES ladder is positively correlated to WAMI and performs similarly to WAMI in predicting a socio-economically sensitive health outcome. Researchers should consider subjective SES tools as an alternative method for measuring SES, particularly in large health studies where data collection is a burden.

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Socioeconomic position over the life-course and subjective social status in relation to nutritional status and mental health among Guatemalan adults

Cited by 8 publications

References 59 publications

Subjective social status is associated with happiness but not weight status or psychological distress: An analysis of three prospective birth cohorts from low- and middle-income countries

Subjective social status is associated with happiness but not weight status or psychological distress: An analysis of three prospective birth cohorts from low- and middle-income countries

Subjective socioeconomic status: an alternative to objective socioeconomic status

Subjective socioeconomic status: an alternative to objective socioeconomic status

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