The role of subjective social status in socioeconomic inequalities in mortality: Evidence from the English longitudinal study of ageing (ELSA)

Abstract

Objectives To study whether subjective social status (SSS) was associated with mortality and its role in the associations between objective socioeconomic position (SEP) measures and mortality. Methods Cox regression was used to model the associations between SSS (measured using a 10-point continuous scale), objective SEP measures and mortality in a sample of 9972 people aged ≥ 50 years from the English Longitudinal Study of Ageing over a 10-year follow-up (2002–2013). Results SSS was associated with all-cause, cardiovascular, cancer and other mortality. Adjustment for covariates fully explained the association between SSS and cancer mortality, and partially the remaining associations. In people aged 50–64 years, SSS mediated to a varying extent the associations between objective SEP measures and all-cause mortality. In people aged ≥ 65 years, SSS did not mediate much these associations, and to some extent was associated with mortality independent of objective SEP measures. In both age groups, wealth partially explained the association between SSS and mortality. Conclusions SSS is a strong predictor of mortality at older ages. Its role in the association between objective SEP and mortality appears to be complex.