Voiceless at Work: Decision-Making Participation, Subjective Power, and Mental Health in a Pandemic

The impact of subjective and objective social status on psychological distress among men and women in Japan

Objective: This study investigates the impact of HIV diagnosis on subjective social status and if changes are linked to health outcomes.Design: Two measures of subjective social status, socio-economic and standing in the community were examined in 342 Australian HIV-positive gay men in 2014. Participants recalled ratings at diagnosis were compared with current ratings.Main outcome measures: Self-reported mental (psychological distress, self-esteem, positive mental health and satisfaction with life) and physical health (self-rated health, CD4 count, viral load).Results: Half of the participants reported improvements in subjective socio-economic status (59%) or standing in the community (52%) since diagnosis, yet one quarter reported socio-economic status (25%) or standing in the community had decreased (23%). Increases in either measure of subjective social status were linked to higher self-esteem, positive mental health, satisfaction with life and better self-rated health. Decreases in subjective social status, however, were strongly linked to poorer outcomes on all mental health measures. Decreases in standing in the community were also associated with poorer physical self-rated health.Conclusion: Most participants reported their subjective social status were the same or better since diagnosis. Changes in subjective social status following diagnosis were strongly linked to mental health outcomes. Those who reported a decrease in subjective social status were particularly vulnerable to mental health problems.

BackgroundCommon mental disorders (CMD) have increased in Sweden, particularly among young women. One acknowledged predictor of CMD is subjective social status (SSS). The aim was to investigate predictors and CMD outcomes of SSS in different gender and age groups of Swedish employees.MethodsData came from eight waves of the Swedish Longitudinal Occupational Survey of Health (SLOSH) from the years 2006-2020 (n = 12,925). Fixed effects models were used to investigate if changes in demographic and socioeconomic (SES) factors predicted a changed SSS and if a changed SSS in turn affected symptoms of depression and sleep disturbances. The analyses were stratified by gender (female/male) and age (21-35/36-50 years). SSS was measured using a 10-rung ladder scale, with higher values denoting higher social status.ResultsAcross groups, the most consistent predictors of a changed SSS were being promoted, which increased SSS (women 36-50: 0.15, 95 % CI: 0.08; 0.23, men 36-50: 0.12 CI: 0.03; 0.20), and a change in occupational status, with higher occupational level increasing SSS (women 21-35: -0.13, CI: -0.23; -0.03, men 36-50: -0.07, CI: -0.11; -0.03). An increase in SSS was associated with a decrease in symptoms of depression in women in both age groups (women 21-35: -0.09 SD per 1 unit increase in SSS, CI: -0.17; -0.01, women 36-50: -0.04, CI: -0.07; -0.01) and in men in the older age group (-0.04, CI: -0.07; -0.02). The association was stronger in younger women than in older (p = 0.042). For both women and men in the older age group an increase in SSS was associated with a decrease in symptoms of sleep disturbances (women 36-50: -0.05, CI: -0.07; -0.03, men 36-50: -0.06, CI: -0.09; -0.03).ConclusionsOccupational level was the most important predictor of SSS across groups and SSS predicted CMD. A change in SSS affected young working women's depressive symptoms particularly while there was an association between SSS and symptoms of sleep disturbances for older workers.Key messages• Occupational level was the most important predictor of SSS across groups.• A change in subjective social status affected young working women’s depressive symptoms particularly.

Introduction Perceptions of social standing have increasingly well-documented relationships with health. Higher subjective social status (SSS) is associated with better psychological well-being among women, and mothers of newborns. The relationship between SSS and psychological distress among mothers of young children, however, is largely unknown. SSS may provide insight into aspects of maternal functioning that are relevant to parenting capacity, as well as insight into future health; in addition, SSS is brief, and may be perceived as less intrusive than other measures of socioeconomic status or mental health. We evaluated the relationship between SSS and psychological distress among mothers of 5-year-old children from diverse socioeconomic backgrounds. Methods One hundred and sixty-two mothers of 5-year old children, who participated in a study of child self-regulation, completed surveys that assessed sociodemographics, mental health, and perceived social support. The MacArthur Scale of SSS used pictures of ten-rung ladders to assess respondents' social position in relation to the US (SES ladder) and their community (community ladder). Quantile regression models were used to assess the relationship between maternal psychological distress (perceived social support, depressive symptoms, anxiety) and the ladders (individually and together), adjusting for maternal age, race, education, and number of children. To examine whether the SSS-health relationships differed by race, the models were also stratified by race. Results Community ladder ranking was positively associated with social support (β=1.34, SE=0.33, p<.001), and negatively associated with depressive symptoms (β=-1.34, SE=0.52, p<.05). SES ladder ranking was positively associated with social support (β=1.17, SE=0.52, p<.05). Findings in the full sample were driven by more robust relationships between psychological distress and community SSS among Black/African-American mothers. Discussion The findings suggest that perceived social standing in one's community is associated with maternal psychological well-being. Community SSS may be particularly influential for Black/African-American mothers' well-being.

Young people's mental health is declining. Depression is a public disease which is increasing internationally, and in Denmark an increase is seen especially among young people. Objective social status is known to be associated with mental health and depression, but little is known about the association between adolescent subjective social status at school and depressive symptoms during young adulthood. The aim was to investigate the association between 15-year-old's subjective social status at school and the development of depressive symptoms at age 18, 21 and 28. The study is a longitudinal study using questionnaire data from The West Jutland Cohort Study Denmark. The study population consisted of adolescents who at baseline, at age 15 (2004), had answered questions about their subjective social status in school using the MacArthur scale-youth version. Answers were categorised into low, medium, and high subjective social status. Outcome data about depressive symptoms was collected at age 18 (2007), age 21 (2010) and age 28 (2017) using the CES-DC and CES-D scales, dichotomised into few or many depressive symptoms. The associations between subjective social status at school at age 15 and depressive symptoms at ages 18, 21 and 28 were analysed using multiple logistic regression. Statistically significant associations were found between low subjective social status at school at age 15 and the odds of many depressive symptoms at all three age points in young adulthood. When adjusting for co-variates the odds ratio for many depressive symptoms at age 18 was OR 3.34 [1.84;6.08], at age 21 OR 3.31 [1.75;6.26] and at age 28 OR 2.12 [1.13;3.97]. The subjective social status of 15-year-olds is associated with depressive symptoms at ages 18, 21 and 28, respectively. It seems that subjective social status at age 15 is of greatest importance for the occurrence of depressive symptoms in the short run, and that the impact attenuates over time.

BackgroundYoung people’s mental health is declining. Depression is a public disease which is increasing internationally, and in Denmark an increase is seen especially among young people. Objective social status is known to be associated with mental health and depression, but little is known about the association between adolescent subjective social status at school and depressive symptoms during young adulthood. The aim was to investigate the association between 15-year-old’s subjective social status at school and the development of depressive symptoms at age 18, 21 and 28.MethodsThe study is a longitudinal study using questionnaire data from The West Jutland Cohort Study Denmark. The study population consisted of adolescents who at baseline, at age 15 (2004), had answered questions about their subjective social status in school using the MacArthur scale-youth version. Answers were categorised into low, medium, and high subjective social status. Outcome data about depressive symptoms was collected at age 18 (2007), age 21 (2010) and age 28 (2017) using the CES-DC and CES-D scales, dichotomised into few or many depressive symptoms. The associations between subjective social status at school at age 15 and depressive symptoms at ages 18, 21 and 28 were analysed using multiple logistic regression.ResultsStatistically significant associations were found between low subjective social status at school at age 15 and the odds of many depressive symptoms at all three age points in young adulthood. When adjusting for co-variates the odds ratio for many depressive symptoms at age 18 was OR 3.34 [1.84;6.08], at age 21 OR 3.31 [1.75;6.26] and at age 28 OR 2.12 [1.13;3.97].ConclusionsThe subjective social status of 15-year-olds is associated with depressive symptoms at ages 18, 21 and 28, respectively. It seems that subjective social status at age 15 is of greatest importance for the occurrence of depressive symptoms in the short run, and that the impact attenuates over time.

Subjec tive social status (SSS) has consistently been linked to health outcomes among Latinx populations, but less is known about how discrimination explains the relationship between SSS and health disparities. While SSS, an individual's perception of her socioeconomic standing, is a robust predictor of health disparities in many societies, discriminatory experiences may impact the relationship between SSS and mental health and health outcomes. Subjective social status can negatively contribute to health disparities through several pathways including the stigma associated with lower social status and poverty. Experiencing discrimination can contribute to feelings of marginalization and therefore decrease individuals' perception of their social status. This study tested discrimination as a mediator of SSS and health disparities among Latinx populations. Using the National Latino and Asian American Study (NLAAS), we identified 2554 Latinx participants to be included in the sample. Participants reported ratings of mental and physical health and exposure to everyday discrimination. Mediation models were used to analyze everyday discrimination as a mediator of SSS and health outcomes. The present results support that SSS is directly associated with ratings of mental and physical health in Latinx individuals. Discrimination was also found to mediate the relationship between SSS and health outcomes. These findings have practice implications for health disparities among Latinx populations. In particular, discrimination may be a major contributing factor to the role of SSS on health outcomes.

Objectives Back pain and poor mental health are interrelated issues in older men. Evidence suggests that socioeconomic status moderates this relationship, but less is known about the role of subjective social status (SSS). This study examined if the association between back pain and mental health is moderated by SSS. Method We used a sample of community-dwelling older men (≥65 years) from the Osteoporotic Fractures in Men Study (N = 5994). Participants self-reported their back pain severity and frequency over the past 12 months. SSS was assessed with the MacArthur Scale of SSS. Mental health was assessed with the SF-12 Mental Component Summary (MCS). Results Severe back pain was associated with lower SF-12 MCS scores (p = .03). Back pain frequency was not associated with SF-12 MCS scores. SSS moderated the back pain and mental health relationship. Among men with higher national or community SSS, the association between back pain severity and SF-12 MCS scores was not significant. However, among men with lower national or community SSS, more severe back pain was associated with lower SF-12 MCS scores (p’s < .001). Among those with lower national or community SSS, greater back pain frequency was also associated with lower SF-12 MCS scores (p’s < .05). Conclusion Where one ranks oneself within their nation or community matters for the back pain and mental health relationship. Higher SSS may be a psychosocial resource that buffers the negative associations of severe and frequent back pain on mental health in older men.

Objective: Both lower subjective social status (SSS)—or viewing oneself as having lower status relative to others—and greater early life stress consistently relate to poorer health in adolescence. Early life stress can also negatively influence one’s social relationships and may thereby shape social status. The present studies investigated how early life stress relates to the development of SSS and how SSS relates to health across the transition to college.Design: In Study 1, 91 older adolescents (Mage = 18.37) reported early life stress, society SSS, and school SSS, and they reported their society SSS and school SSS again 2 years later. In Study 2, 94 first-year college students (Mage = 18.20) reported early life stress and society SSS at study entry and reported their dorm SSS, university SSS, and mental health monthly throughout the year.Results: Greater early life stress was related to lower society SSS, but not school SSS, in both studies. In Study 2, dorm and university SSS and early life stress were uniquely related to mental health, although associations weakened over time.Conclusion: Early life stress may predispose people to have low society SSS, and both low school SSS and high early life stress may increase risk for poorer health during transition periods.

Prior research has found that the higher one's perceived status in society, the better one's mental health and well-being. The present research used a longitudinal design to investigate whether social contact with friends mediated this relation between subjective social status and mental health and well-being among firstyear undergraduate students at an Australian university (Wave 1 N = 749, Wave 2 N = 314). Participants completed an online survey that included measures of subjective social status, social contact with university friends during the past week, and mental health and well-being during the past week. Multiple regression analyses found that subjective social status positively predicted amount of social contact with university friends, and that both of these variables positively predicted subsequent mental health and well-being. Furthermore, bootstrapped mediation tests found that social contact with university friends acted as a significant mediator of the relations between social status and me...

The trajectory of subjective social status and its influencing factors in the transition period of freshmen in senior high school

Eliminating health disparities, including those that are a result of socioeconomic status (SES), is one of the overarching goals of Healthy People 2010. This article reports on the development of a new, adolescent-specific measure of subjective social status (SSS) and on initial exploratory analyses of the relationship of SSS to adolescents' physical and psychological health. A cross-sectional study of 10 843 adolescents and a subsample of 166 paired adolescent/mother dyads who participated in the Growing Up Today Study was conducted. The newly developed MacArthur Scale of Subjective Social Status (10-point scale) was used to measure SSS. Paternal education was the measure of SES. Indicators of psychological and physical health included depressive symptoms and obesity, respectively. Linear regression analyses determined the association of SSS to depressive symptoms, and logistic regression determined the association of SSS to overweight and obesity, controlling for sociodemographic factors and SES. Mean society ladder ranking, a subjective measure of SES, was 7.2 +/- 1.3. Mean community ladder ranking, a measure of perceived placement in the school community, was 7.6 +/- 1.7. Reliability of the instrument was excellent: the intraclass correlation coefficient was 0.73 for the society ladder and 0.79 for the community ladder. Adolescents had higher society ladder rankings than their mothers (micro(teen) = 7.2 +/- 1.3 vs micro(mom) = 6.8 +/- 1.2; P =.002). Older adolescents' perceptions of familial placement in society were more closely correlated with maternal subjective perceptions of placement than those of younger adolescents (Spearman's rho(teens <15 years) = 0.31 vs Spearman's rho(teens 15 years) = 0.45; P <.001 for both). SSS explained 9.9% of the variance in depressive symptoms and was independently associated with obesity (odds ratio(society) = 0.89, 95% confidence interval = 0.83, 0.95; odds ratio(community) = 0.91, 95% confidence interval = 0.87, 0.97). For both depressive symptoms and obesity, community ladder rankings were more strongly associated with health than were society ladder rankings in models that controlled for both domains of SSS. This new instrument can reliably measure SSS among adolescents. Social stratification as reflected by SSS is associated with adolescents' health. The findings suggest that as adolescents mature, SSS may undergo a developmental shift. Determining how these changes in SSS relate to health and how SSS functions prospectively with regard to health outcomes requires additional research.

ObjectiveWe study how life course objective socioeconomic position (SEP) predicts subjective social status (SSS) and the extent to which SSS mediates the association of objective SEP with nutritional status and mental health outcomes. MethodsWe use data from participants of the INCAP Longitudinal Study 1969–2018 (n = 1258) from Guatemala. We use the MacArthur ladder for two measures of SSS - perceived community respect and perceived economic status. We estimate the association of SSS with health outcomes after adjusting for early life characteristics and life course objective SEP (wealth, schooling, employment) using linear regression. We use path analysis to study the extent of mediation by SSS on the health outcomes of body mass index (BMI; kg/m2), psychological distress (using the WHO Self-Reported Questionnaire; SRQ-20) and happiness, using the Subjective Happiness Scale (SHS). ResultsMedian participant rating was 5 [IQR: 3–8] for the perceived community respect and 3 [IQR: 1–5] for the perceived economic status, with no differences by sex. Objective SEP in early life and adulthood were predictive of both measures of SSS in middle adulthood as well as health outcomes (BMI, SRQ-20 and SHS). Perceived community respect (z-scores; 1 z = 3.1 units) was positively associated with happiness (0.13, 95 % CI: 0.07, 0.19). Perceived economic status (z-scores; 1 z = 2.3 units) was inversely associated with psychological distress (−0.28, 95 % CI: −0.47, −0.09). Neither measure of SSS was associated with BMI. Neither perceived community respect nor perceived economic status attenuated associations of objective SEP with health outcomes on inclusion as a mediator. ConclusionsSubjective social status was independently associated with happiness and psychological distress in middle adulthood after adjusting for objective SEP. Moreover, association of objective SEP with health was not mediated by SSS, suggesting potentially independent pathways.

Using nationally representative longitudinal data from 2010 to 2018 in China, this study systematically investigates the relationship between Subjective Social Status (SSS) and health (physical health and mental health) in the Chinese adult population. By applying between-within model, we disentangle the relationship between health outcomes and: (1) between-individual differences in SSS and (2) within-individual variations of SSS across time. In addition, to explore SSS mobility and trajectory, we further decomposed SSS into lagged SSS and the change between the current and lagged SSS (mobility). We find that there is significantly positive and unique relationship (independent of Objective Social Status (OSS)) between SSS and physical and mental health. However, for physical health, we observed an Inverse-U effect of average SSS, after some point (SSS=3.93), higher average SSS is associated with a score decrease. Through heterogeneity analysis, we find that for physical health, within- and between-effects decreases with age and for mental health, the within effect is only significant among the urban population. Individuals with high expected mobility are also found to have significantly better health. These findings show that the personal relative deprivation has negative, particularly salient and unique effects on the health of the Chinese population, and it is important to consider the dynamic nature of SSS.

This study examined the associations of subjective social status (SSS), objective measures of socio-economic status (SES), and depression among graduate-level college students. This cross-sectional study surveyed 800 graduate-level students attending a major public research university in the Mid-Atlantic region of the United States. SSS was derived from the MacAuthur Scale of Subjective Social Status, SES from respondents’ parental income and education, and depression from the Patient Health Questionnaire-2. Multivariate logistic regression analysis was used to examine the relationship between SSS, SES, and depression controlling for covariates. The overall prevalence of depression in the sample was 11.1%. Regression modeling demonstrated that low SSS was predictive of depression (OR = 0.65; 95% CI: 0.56 - 0.77) whereas all objective measures of SES were non-significant. Low SSS is a relevant risk factor for depression and should be considered in mental health counseling and academic advising of graduate-level students as it may be amenable to intervention.