Does Subjective Social Status Predict Self-Rated Health in Chinese Adults and Why?

Abstract

A positive relationship between subjective social status (SSS) and health has been documented in many countries, however, many studies rely on non-representative, cross-sectional samples. Potential mechanisms underlying the association between SSS and health have been proposed but empirical investigation remains scarce. Capitalizing on nationally representative data from the 2010–2016 China Family Panel Studies (CFPS), this study examines the longitudinal association between SSS and self-rated health in Chinese adults 20–70 years old. Estimates from lagged dependent variable models confirm a linear relationship between current SSS and self-rated health two years later over a 6-year follow-up period, after adjusting for education, occupation, income, and other demographic controls. This relationship remains robust after adjusting for additional indicators of objective socioeconomic status (SES) including household wealth, education of the spouse, parental literacy, and political capital. Mediation analysis shows that a large proportion (about 60%) of this association can be explained by such psychosocial factors as future prospects, life satisfaction, and mental illness. For Chinese adults, SSS is an important predictor of health not because it is a comprehensive measure of multidimensional SES, but because of a salient psychosocial pathway.