Subjective assessments of income and social class on health and survival: An enigma

doi:10.1016/j.ssmph.2017.10.005

. 2017 Oct 31:6:295-300.

doi: 10.1016/j.ssmph.2017.10.005. eCollection 2018 Dec.

Subjective assessments of income and social class on health and survival: An enigma

Shukai Li^{1

2}, Qianyun Zhang³, Peter Muennig^{1

2}

Affiliations

¹ Global Research Analytics for Population Health, Columbia University, New York City, NY, USA.
² Department of Health Policy and Management, Columbia University, New York City, NY, USA.
³ Department of Pathology, University of New Mexico, Albuquerque, NM, USA.

PMID: 30519626
PMCID: PMC6259035
DOI: 10.1016/j.ssmph.2017.10.005

Subjective assessments of income and social class on health and survival: An enigma

Shukai Li et al. SSM Popul Health. 2017.

. 2017 Oct 31:6:295-300.

doi: 10.1016/j.ssmph.2017.10.005. eCollection 2018 Dec.

Authors

Shukai Li^{1

2}, Qianyun Zhang³, Peter Muennig^{1

2}

Affiliations

¹ Global Research Analytics for Population Health, Columbia University, New York City, NY, USA.
² Department of Health Policy and Management, Columbia University, New York City, NY, USA.
³ Department of Pathology, University of New Mexico, Albuquerque, NM, USA.

PMID: 30519626
PMCID: PMC6259035
DOI: 10.1016/j.ssmph.2017.10.005

Abstract

We examined the association between various measures of subjective social class identification (SSCI) and self-rated health as well as survival using the 2014 General Social Survey-National Death Index dataset (n = 21,108). We used multinomial logistic regression models to assess the association between SSCI and self-rated health and used Cox proportional hazards to assess the association between SSCI and survival. All analyses were adjusted for age, year at interview, race, gender, family income, and educational attainment level. The measures of SSCI that we had available were strongly correlated with self-rated health after controlling for objective measures of social status. For example, those who saw themselves as lower class were nine times as likely to self-report poor rather than excellent health status (odds ratio = 8.69; 95% confidence interval = 5.04-14.98) compared with those saw themselves as upper class. However, no such associations were observed for survival. While our alternative measures of SSCI were important predictors of self-rated health, they were not predictive of survival. This suggests that there may be potential confounding between two perceptions: SSCI and self-rated health.

Keywords: Epidemiology; Health policy; Health status; Longitudinal research; Self-rated health; Socioeconomic disparities and health; Subjective social status; Survival time.

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References

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1. Adler N.E., Epel E.S., Castellazzo G., Ickovics J.R. Relationship of subjective and objective social status with psychological and physiological functioning: Preliminary data in healthy white women. Health Psychology. 2000;19(6):586–592. - PubMed
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[1] Adler N.E., Boyce T., Chesney M.A., Cohen S., Folkman S., Kahn R.L. Socioeconomic status and health. The challenge of the gradient. American Psychologist. 1994;49(1):15–24. - PubMed

[2] Adler N.E., Boyce T., Chesney M.A., Cohen S., Folkman S., Kahn R.L. Socioeconomic status and health. The challenge of the gradient. American Psychologist. 1994;49(1):15–24. - PubMed

[3] Adler N.E., Epel E.S., Castellazzo G., Ickovics J.R. Relationship of subjective and objective social status with psychological and physiological functioning: Preliminary data in healthy white women. Health Psychology. 2000;19(6):586–592. - PubMed

[4] Adler N.E., Epel E.S., Castellazzo G., Ickovics J.R. Relationship of subjective and objective social status with psychological and physiological functioning: Preliminary data in healthy white women. Health Psychology. 2000;19(6):586–592. - PubMed

[5] Adler N.E., Marmot M.G., McEwen B., Stewart J. Socioeconomic status and health in industrial nations: Social, psychological and biological pathways. Annals of the New York Academy of Sciences. 1999;896 - PubMed

[6] Adler N.E., Marmot M.G., McEwen B., Stewart J. Socioeconomic status and health in industrial nations: Social, psychological and biological pathways. Annals of the New York Academy of Sciences. 1999;896 - PubMed

[7] Adler N.E., Ostrove J.M. Socioeconomic status and health: What we know and what we don’t. Socioeconomic Status and Health in Industrial Nations. 1999;896:3–15. - PubMed

[8] Adler N.E., Ostrove J.M. Socioeconomic status and health: What we know and what we don’t. Socioeconomic Status and Health in Industrial Nations. 1999;896:3–15. - PubMed

[9] Bessudnov A., McKee M., Stuckler D. Inequalities in male mortality by occupational class, perceived status and education in Russia, 1994–2006. The European Journal of Public Health. 2012;22(3):332–337. - PubMed

[10] Bessudnov A., McKee M., Stuckler D. Inequalities in male mortality by occupational class, perceived status and education in Russia, 1994–2006. The European Journal of Public Health. 2012;22(3):332–337. - PubMed

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Subjective assessments of income and social class on health and survival: An enigma

Affiliations

Subjective assessments of income and social class on health and survival: An enigma

Authors

Affiliations

Abstract

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