Abstract
BackgroundTo investigate the impact of the gap between subjective and objective social status on health-related quality of life.MethodsWe analyzed data from 12,350 participants aged ≥18 years in the Korean Health Panel Survey. Health-related quality of life was measured by EuroQol-Visual analogue scale. Objective (income and education) and subjective social class (measured by MacArthur scale) was classified into three groups (High, Middle, Low). In terms of a gap between objective and subjective social class, social class was grouped into nine categories ranging from High–High to Low–Low. A linear mixed model was used to investigate the association between the combined social class and health-related quality of life.ResultsThe impact of the gap between objective and subjective status on Health-related quality of life varied according to the type of gap. Namely, at any given subjective social class, an individual’s quality of life declined with a decrease in the objective social class. At any given objective social class (e.g., HH, HM, HL; in terms of both education and income), an individual’s quality of life declined with a one-level decrease in subjective social class.ConclusionOur results suggest that studies of the relationship between social class and health outcomes may consider the multidimensional nature of social status.Electronic supplementary materialThe online version of this article (doi:10.1186/s12955-015-0319-0) contains supplementary material, which is available to authorized users.
Highlights
Several studies of health inequality have shown that the traditional measure of socioeconomic status is an important predictor of health [1,2,3]
We found that when subjective social status was rated one level below objective social status (i.e., High, Medium, and Low income and education levels), average health-related quality of life decreased for income (HH, HM, and HL: 77.00, 75.30, and 73.56, respectively; MH, MM, and ML: 75.57, 74.06, and 72.34, respectively; and LH, LM, and LL: 73.26, 70.52, and 65.12 respectively; p < 0.0001) and education
Several previous studies have established the relationship between the effects of socioeconomic status (SES) on health outcomes and health-related quality of life
Summary
Several studies of health inequality have shown that the traditional measure of socioeconomic status (i.e., education, income, and occupation) is an important predictor of health [1,2,3]. In addition to the conventional measures of socioeconomic status (SES), subjective social class, which refers to “the individual’s perception of his own position in the social hierarchy,” is a novel indicator of social level [9] and a better predictor of health [10, 11], such as physical [12, 13], mental health [10, 14,15,16], diseases [17, 18], and mortality [19] Both social classes affect healthrelated quality of life or self-reported health. To investigate the impact of the gap between subjective and objective social status on health-related quality of life
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