Associations Of Subjective Social Status Research Articles

Lower subjective social status is associated with increased adiposity and self-reported eating in the absence of hunger due to negative affect among children reporting teasing distress.

Low social standing and teasing are independently associated with increased body mass index (BMI) and overeating in children. However, children with low social status may be vulnerable to teasing. We tested the statistical interaction of subjective social status (SSS) and subjective socioeconomic status (SSES) and teasing distress on BMI, fat mass index (FMI), and eating in the absence of hunger (EAH) in children (Mage = 13.09 years, SD = 2.50 years; 27.8% overweight/obese). Multiple linear regressions identified the main effects of self-reported SSS (compared to peers in school), distress due to teasing, and their interaction on BMI (n = 115), FMI (n = 114), and child- (n = 100) and parent-reported (n = 97) EAH. Teasing distress was associated with greater BMI, FMI, and child-reported EAH due to negative affect (a subscale of EAH) and total EAH scores. There were no associations of SSS with these outcomes. However, there was an interaction between SSS and teasing distress for BMI, FMI, and EAH from negative affect such that lower SSS was associated with higher BMI, FMI, and EAH from negative affect in the presence of teasing distress. However, there were no main effects or interactions (with teasing distress) of SSES on the outcomes. These findings suggest that the relationship between lower SSS and increased adiposity and overeating behaviors may be exacerbated by other threats to social standing, such as teasing. Children exposed to multiple social threats may be more susceptible to eating beyond physiological need and obesity than those who experience a single form of perceived social disadvantage.

O.4.3-8 Associations of subjective social status with physical activity and sedentary time among lower secondary school students

Abstract Purpose The low level of physical activity among young people has become a common societal concern. This study sought new information on the background to adolescents’ physical activity. The aim was to determine whether adolescents’ subjective social status is related to their physical activity. Methods The data was collected as part of follow-up research and evaluation of the Finnish Schools on the Move programme in 2012–2015. The data was collected through student surveys, measuring adolescents’ physical activity with accelerometers, and observing and interviewing secondary school students. The associations between adolescents’ subjective social status and physical activity, as well as the factors related to the subjective social status were studied using both quantitative and qualitative methods. Results Adolescents’ subjective social status was associated with physical activity. The subjective social status in school was positively associated with whole-day moderate- to vigorous-intensity physical activity. Adolescents’ high perceived social status in school was significantly associated with physical activity among boys and girls during break times, participation in planning break-time activities among girls, and participation in arranging common school events among boys and girls. Subjective social status in school was negatively associated with sedentary time in school. A high subjective social status in school was also associated with more opportunities for activity created with schoolmates. A high subjective social status was also associated with a wider environment for physical activities in school, which were related to the interactive relationships between adolescents. There were school premises that not everyone had access to, and one limiting factor may be the low subjective social status in school. Conclusions The different subjective experiences of school-based social networks are linked to adolescents’ physical activity and should be taken into account when considering the possibilities of increasing adolescents’ physical activity. Although the foundation of an active lifestyle is largely built on one’s own family, the school still has the potential to compensate for differences in family background with its own actions. These interventions should place greater emphasis on peer relations and youth participation rather than the role of school staff. Support/Funding Source The Ministry of Education and Culture of Finland.

Subjective social status, race, and metabolic syndrome in women with breast cancer.

To evaluate the association of subjective social status (SSS) with metabolic syndrome (MetS) severity and its potential contribution to racial health disparities in women with breast cancer. Multicenter cross-sectional study (10 US hospitals) in women (n = 1206) with primary diagnosis of invasive breast cancer received during Mar/2013-Feb/2020. Participants, self-identified as non-Hispanic White or Black, underwent physical and laboratory examinations and survey questions assessing socioeconomic parameters, medical history, and behavioral risks. SSS was measured with the 10-rung MacArthur scale. MetS severity was measured with a validated Z-Score. Generalized linear mixed modeling was used to analyze the associations. Missing data were handled using multiple imputation. Average age was 58years. On average, the SSS of Black women, given equivalent level of income and education, was lower than the SSS of White women: 6.6 (6.1-7.0) vs 7.7 (7.54-7.79) among college graduates and 6.8 (6.4-7.2) vs 7.6 (7.5-7.8) among women in the high-income category (> $75,000). In multivariable analysis, after controlling for age, income, education, diet, and physical activity, increasing SSS was associated with a decrease in MetS-Zscore, -0.10 (-0.16 to -0.04) per every 2 rung increase in the MacArthur scale. Black women with breast cancer rank their SSS lower than White women with breast cancer do at each level of income and education. As SSS is strongly associated with MetS severity these results identify potentially modifiable factors that contribute to racial disparities.

Body mass index mediates the direct association of subjective social status and hypertension in a fulani west African immigrant sample.

The inverse association between social status and hypertension (HTN) often observed in native-born populations may not hold among immigrants from regions where larger bodies are markers of success. Qualitative evidence suggests that many African immigrant groups view larger body size as a marker of social status. The present study examined the relationships between subjective social status, body mass index (BMI), and HTN in a cross-sectional, community snowball sample of 218 West African Fulani immigrants living in New York City. Over a third of the sample met criteria for HTN. Higher subjective social status within the Fulani community was directly associated with higher likelihood of HTN. BMI fully mediated this association. Member checking revealed a community narrative in which being heavy indicated higher status. These findings provide the first quantitative evidence that aesthetic markers of status within African immigrant communities may comprise risks to cardiovascular health. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Association of subjective social status with epigenetic aging among Black and White women

ObjectiveSubjective social status (SSS), an individual’s assessment of their own social status in relation to others, is associated with health and mortality independently of objective SES; however, no studies have tested whether SSS influences epigenetic aging. The current study examines if SSS is associated with epigenetic age acceleration in both Black and White women, independently of objective SES measured during both childhood and adulthood. MethodFor 9- and 10-year-old Black and White girls, parental education and annual household income was obtained. At ages 39–42, 361 participants (175 Black, 186 White) reported their current education, household income, and SSS, and provided saliva to assess age acceleration using the GrimAge epigenetic clock. Linear regression estimated the association of SSS with epigenetic age acceleration, controlling for objective SES (current education, current income, parents’ education, income during childhood), smoking, and counts of cell types. ResultsWhen all objective SES variables were included in the model, SSS remained significantly associated with epigenetic age acceleration, b = − 0.31, p = .003, ß = − 0.15. Black women had significantly greater age acceleration than White women, (t(359) = 5.20, p > .001, d = 0.55) but race did not moderate the association between SSS and epigenetic age acceleration. ConclusionsWomen who rated themselves lower in SSS had greater epigenetic age acceleration, regardless of income and education. There was no difference by race for this association.

110. The Association of Subjective Social Status with Adverse Childhood Experiences and Socioeconomic Status Among Hispanic Adolescents

Subjective Social Status (SSS), or one’s self-perceived rank on the social ladder, is a strong contributor to adolescent health and psychosocial wellbeing. Among adolescents, low SSS has been associated with increased risk for obesity, depression, and future substance use. SSS is often assessed in the context of one’s community or society, and is paired with traditional measures of socioeconomic status (SES) to capture objective status and subjective perceptions regarding one’s trajectory and opportunities in life.

Association of Subjective Social Status With Life's Simple 7s Cardiovascular Health Index Among Hispanic/Latino People: Results From the HCHS/SOL

BackgroundEvidence suggests that subjective (perceived) social status (SSS) may predict health outcomes more strongly than objective social status, but little is known about the relationship between SSS and cardiovascular health (CVH). This study focuses on this relationship among diverse Hispanic/Latino adults because while poor CVH profiles are prevalent in this population, immigration complicates attempts to measure their social status.Methods and ResultsWe analyzed baseline HCHS/SOL (Hispanic Community Health Study/Study of Latinos) data on 15 374 Hispanic/Latino adults aged 18 to 74 years in 2008 to 2011. SSS was assessed using the McArthur Scale, a 10‐rung “social ladder.” CVH was based on levels of 7 metrics defined by the American Heart Association. Linear and logistic regressions were used to examine cross‐sectional associations of SSS with CVH (overall and single metrics) after adjusting for objective social status, demographic, and health factors. Less than half of the population (46%) had Ideal scores in ≥4 metrics of CVH. In multivariable‐adjusted models, an increase in SSS was associated with a higher overall CVH score (β=0.04; 95% CI, 0.01–0.06) and greater likelihood of Ideal levels of body mass index, physical activity, and fasting blood glucose levels. Nativity and time in the United States modified the association between SSS and Ideal smoking.ConclusionsSubjective measures of social status can enhance an understanding of CVH among Hispanic/Latino people. Future studies should explore the stability of SSS over time in comparison with objective social status and the mechanisms through which SSS may influence CVH.

Abstract P396: Association of Subjective Social Status With Allostatic Load in The Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Introduction: Subjective social status (SSS) is inversely related to allostatic load (AL) markers, but little is known in Hispanics/Latinos. We assessed the hypotheses that SSS would be inversely associated with total AL and subsystem scores, regardless of objective socioeconomic status (OSS). Methods: Data were from baseline of the HCHS/SOL (n = 12,722, aged 18-74y). We assessed SSS using a 10-step ladder. Participants identified on which step they stood in relation to other people in the U.S. Higher scores indicated higher SSS (range: 1-10). Participants self-reported OSS as household income, educational attainment, and employment status. AL was comprised of 16 physiological markers from the parasympathetic (n=2; heart rate variability), inflammation (n=2; C-reactive protein, white blood cell), metabolic (anthropometrics, lipids, glucose, insulin resistance; n=8), and cardiopulmonary (blood and pulse pressures, resting heart rate, lung function; n=4) subsystems. Each marker was assigned a score of 1 if the value exceeded clinical cut-offs (or high-risk quartiles) or the participant reported taking medication to alter the marker. Otherwise, the marker was assigned a score of 0. Scores were summed across the 16 markers to create an AL score (0-16), with higher scores indicating higher AL. Scores were then dichotomized as high (vs. low) if scores were ≥ AL and subsystem medians. Multivariate-adjusted, survey-weighted linear and logistic regression models tested the association of SSS with AL and subsystem scores. Results: Sample means (95% CI) for SSS and AL were 4.4 (4.3-4.5) and 4.2 (4.1-4.3), respectively. A one-step increase on the SSS ladder was associated with lower AL ((β(SE): -0.1(0.02), p=0.003) and metabolic system (-0.04(0.01), p=0.001) scores. After adjusting for OSS, the association between SSS and AL was attenuated (-0.03(0.02), p=0.09), but remained significant for metabolic system scores (-0.03(0.01), p=0.01). When modeling dichotomized AL, a one-step increase was associated with lower odds of high AL (Odds Ratio (OR); 95% Confidence Intervals (CI): 0.94 (0.91-0.98), p=0.001), high parasympathetic system (0.96 (0.93-1.00), p=0.03), and high metabolic system (0.95 (0.92-0.98)) scores. After adjusting for OSS, higher SSS remained associated with lower odds of high AL (0.95 (0.92-0.99), p=0.01) and high metabolic system (0.96 (0.92-0.99), p=0.01) scores, but the association between SSS and lower parasympathetic subsystem scores was attenuated (0.97 (0.94-1.00), p=0.08). SSS was not associated with inflammation or cardiopulmonary subsystems. Conclusions: Among Hispanics/Latinos living in the U.S, OSS attenuated the relationship between SSS and AL. SSS may be influencing AL through the metabolic system, and could provide unique psychological and biobehavioral targets for reducing metabolic risk disparities among Hispanics/Latinos living in the U.S.

The role of emotion dysregulation in the association between subjective social status and eating expectancies among college students

Objective: Research suggests that college is a risky period for changes in eating behavior and beliefs. Although social health determinants relate to health behavior changes, research has not explored subjective social status, one’s societal standing, in terms of eating expectancies among college students. The present study examined the emotion dysregulation in association between subjective social status and eating expectancies among college students. Participants: Participants were a diverse sample of 1,589 college students (80.4% females; Mage = 22.2 years, SD = 5.27) from an urban university. Results: Results showed a significant indirect association of subjective social status via emotion dysregulation in relation to expectancies of eating to help manage negative affect, to alleviate boredom, and to lead to feeling out of control. Conclusion: These findings provide evidence that college students with lower subjective social status may have a higher risk for dysregulated emotions, and consequently, expressing maladaptive eating expectancies.

Resilience in African American Women at Risk for Cardiovascular Disease: an Exploratory Study

African Americans (AAs) have a higher risk for cardiovascular disease (CVD) which is not fully explained by traditional CVD risk factors such as smoking, obesity, hypertension, and diabetes. Evidence demonstrates that chronic stress, low subjective status, and lack of social support play important roles in increasing the risk for CVD, particularly in minority women. Increasing evidence demonstrates that resilience may ameliorate the effect of social stressors on the development of CVD. However, little is known about the social context that may influence resilience in AA women. Therefore, the purpose of this exploratory study was to examine the predictors of resilience in AA women at risk for CVD. A cross-sectional sample of AA women (N = 104) participated in the study. Participants completed measures of resilience, subjective social status, social support, and general stress. Findings revealed that participants had low levels of resilience as measured by the Connor-Davidson Resilience Scale (mean = 50.3 ± 11.4) compared to norms. Results of the multiple linear regression analysis demonstrated that both subjective social status in relation to others in the USA (p = 0.021) and perceived social support (p < 0.001) predicted greater level of resilience. The model, controlling for age, marital status, income, level of education, and general stress, accounted for a significant proportion of variance (F[8,75] = 6.6, p < .001), explaining 41.7% of the variation in resilience. Results suggest that subjective social status and social support contribute to perceived resilience in AA women. Additional research is needed to assess the association of subjective social status and social support in longitudinal studies.

Associations of subjective social status with accelerometer-based physical activity and sedentary time among adolescents

ABSTRACTThis study examined the associations of subjective social status (SSS) with physical activity (PA) and sedentary time (ST) among adolescents. The study population consisted of 420 Finnish adolescents aged 13 to 14 years. The adolescents reported their own SSS within their school (school SSS) and their family’s social position within society (society SSS) based on the youth version of the Subjective Social Status Scale. Adolescents’ moderate- to vigorous-intensity physical activity (MVPA) and ST were measured objectively by accelerometers and analyzed separately for the whole day and the school day. The associations between SSS and MVPA and ST outcomes were analyzed using multilevel modeling. School SSS was positively associated with whole-day MVPA and negatively associated with school-time ST. Society SSS was not significantly associated with objectively measured MVPA or ST. Both MVPA and ST are important behavioral determinants of health. As an important correlate of MVPA and ST, school SSS should be addressed by providers when discussing obesity risk and healthy behaviors with adolescents.

Abstract P114: Association of Subjective Social Status With Cardiovascular Health in Hispanics/Latinos

Introduction: Evidence suggests that subjective social status (SSS)—perceived status in the social hierarchy—may be more strongly associated with health than objective markers of social status (OSS), income and education. Compared to persons with high SSS, those with low SSS report poorer self-rated physical health and have higher rates of medical comorbidities. Little is known about the relationship between SSS and ideal cardiovascular health (CVH) profiles defined by the American Heart Association (AHA), particularly among diverse Hispanic/Latino adults. Hypothesis: Higher SSS will be associated with more favorable CVH profiles. Methods: We analyzed baseline HCHS/SOL data † on adults ages 18-74 in 2008-11 (N=15,440). SSS was assessed using the McArthur Scale, a 10-rung “social ladder” to specify social rank (scores range from 1-10; higher scores indicate higher SSS). CVH was defined based on levels of 7 metrics: diet, body mass index (BMI), physical activity, cholesterol, blood pressure, fasting glucose, and smoking status; levels of each metric were categorized as ideal, intermediate and poor using AHA criteria. A composite CVH score was calculated by summing across metrics (scores range from 0-14; higher scores indicate better CVH). Linear and logistic regressions were used to examine cross-sectional associations of SSS with CVH (overall and single metrics), after adjusting for OSS, demographics, Hispanic/Latino group, study center, marital status, insurance, prevalent coronary heart disease, and depressive symptoms (CESD). Results: In multivariate-adjusted models, each one unit increase in SSS* was associated with a higher overall CVH score (β = 0.03, 95% CI 0.004, 0.057, p &lt;0.05); higher SSS was also positively associated with ideal levels of BMI, physical activity, and fasting blood glucose levels (see Table 1). Conclusions: These findings suggest an association between SSS and CVH among diverse Hispanic/Latino adults. Future studies will explore the mechanisms through which SSS may influence CVH.

The Impact of Subjective and Objective Social Status on Depression in a Cohort of Graduate-Level Students

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.

Subjective Social Status and Anxiety and Depressive Symptoms and Disorders among Low Income Latinos in Primary Care: The Role of Emotion Dysregulation

Accumulating evidence suggests that Latinos experience greater anxiety- and depression-related health disparities compared to non-Latino Whites. Perceived social status may help to account for these mental health disparities among Latinos, but the specific mechanisms underlying these relations are still unknown. One possible explanation for this relation is emotion dysregulation. Therefore, the present study sought to test whether emotion dysregulation maintains an explanatory role in the relation between subjective social status and anxiety and depressive symptoms and disorders among low income Latinos. Latino adults (N = 383; M age = 38.9 years, SD = 11.4; 86.2% female) were recruited for this study from a primary care health clinic. As hypothesized, there was a statistically significant indirect association of subjective social status via emotion dysregulation in relation to depressive (B = −0.42, Bootstrapped 95% CI [−0.81, −0.08], completely standardized estimate = −0.07), suicidal (B = −0.04, Bootstrapped 95% CI [−0.10, −0.01], completely standardized estimate = −0.04), social anxiety (B = −0.09, Bootstrapped 95% CI [−0.20, −0.02], completely standardized estimate = −0.05), and anxious arousal symptoms (B = −0.13, Bootstrapped 95% CI [−0.28, −0.02], completely standardized estimate = −0.05), as well as number of depressive and anxiety disorder diagnoses (B = −0.03, Bootstrapped 95% CI [−0.05, −0.004], completely standardized estimate = −0.06). Post-hoc tests evaluated indirect associations of subjective social status via specific facets of emotion dysregulation. Overall, the current study found novel empirical evidence for the explanatory role of emotion dysregulation in the associations between subjective social status and anxiety/depressive symptoms and disorders in a sample of economically disadvantaged Latinos. Future work is needed to develop and evaluate targeted interventions that can modify these constructs to offset anxiety/depressive symptoms and disorders among this population.

The Potential Explanatory Role of Perceived Stress in Associations Between Subjective Social Status and Health-Related Quality of Life Among Homeless Smokers.

Homeless individuals smoke at high rates relative to the general population and are at heightened risk of tobacco-related illnesses and poor health-related quality of life (HRQoL). Homeless smokers also report low subjective social status (SSS) or perceived social standing relative to others. SSS may contribute to poor HRQoL, potentially through perceived stress. The current study examined the role of perceived stress in the association of SSS and HRQoL among 227 (70.9% male, Mage = 43.2) homeless smokers. Participants completed self-report measures of SSS, perceived stress, and HRQoL. Perceived stress partially explained the relation between SSS (United States and Community) and HRQoL in covariate-adjusted analyses. Results suggested that perceived stress is a pathway through which SSS contributes to HRQoL among homeless smokers. Findings broaden current understanding of the impact of social disadvantage and perceived stress on HRQoL among homeless smokers.

Clues of subjective social status among young adults

We investigate determinants of subjective social status (SSS) as measured by respondents placing themselves on a ten-rung ladder from least to most “money”, “education” and “respected job”, in a large sample of young adults. The most potent clues of SSS are proximate in the life course, reflecting educational attainment and current socioeconomic and job situation, rather than distal characteristics such as family background, although relatively distal High school GPA has a lingering effect. Additional analyses reveal that College selectivity has a substantial impact on SSS, net of other variables in the model; Currently married does not significantly contribute to SSS, but contrary to some expectations Number of children significantly lowers SSS. We find no evidence of greater “status borrowing” by women as associations of SSS with shared household characteristics (Household income, Household assets, Home ownership) do not differ by gender. Our findings for these young adults support the conclusion of earlier research that SSS reflects a “cognitive averaging” of standard dimensions of socioeconomic status.

Associations of Subjective Social Status with Nondaily and Daily Smoking

To explore associations between subjective social status (SSS) and smoking level among 2274 adult current smokers. Associations were investigated using a covariate-adjusted proportional odds cumulative logit model. Moderation (via race/ethnicity or sex) and mediation (via depressive symptoms, social/emotional support, or life satisfaction) were explored in additional models. Higher SSS was associated with greater likelihood of nondaily versus light daily or moderate/ heavy daily smoking (p = .017). Life satisfaction partially mediated the association of SSS and smoking level (p = .003). Higher SSS was associated with greater likelihood of nondaily relative to light daily or moderate to heavy smoking, potentially via greater life satisfaction. Additional studies are needed to confirm these findings.

Associations of subjective social status with physical activity and body mass index across four Asian countries.

Objective. The aims of this study were to (1) assess physical activity and weight status differences and (2) explore the direction and shape of subjective social status (SSS) association with physical activity and weight status within four Asian countries. Methods. Cross section data of adult respondents from the nationally representative East Asian Social Survey were used for analyses. Logistic regression stratified by gender was conducted for the first aim, and simple and quadratic logistic regression models were used for the second. Results. SSS was significantly associated with odds of weekly or daily physical activity across all countries and genders, except for South Korean and Japanese females. Quadratic models provided significantly better fit for Chinese males (LR (d.f. = 1) = 6.51, P value <.05) and females (LR (d.f. = 1) = 7.36, P value <.01), South Korean males (LR (d.f. = 1) = 4.40, P value <.05), and Taiwanese females (LR (d.f. = 1) = 4.87, P value <.05). Conclusions. This study provides a comparable cross Asian country measure of moderate-to-vigorous physical activity and new findings that a connection exists between SSS and physical activity. Differences of class distinction help explain the different shaped SSS relationships.

Subjective social status and psychosocial and metabolic risk factors for cardiovascular disease among African Americans in the Jackson Heart Study

Subjective social status has been shown to be inversely associated with multiple cardiovascular risk factors, independent of objective social status. However, few studies have examined this association among African Americans and the results have been mixed. Additionally, the influence of discrimination on this relationship has not been explored. Using baseline data (2000–2004) from the Jackson Heart Study, an African American cohort from the U.S. South (N = 5301), we quantified the association of subjective social status with selected cardiovascular risk factors: depressive symptoms, perceived stress, waist circumference, insulin resistance and prevalence of diabetes. We contrasted the strength of the associations of these outcomes with subjective versus objective social status and examined whether perceived discrimination confounded or modified these associations. Subjective social status was measured using two 10-rung “ladders,” using the U.S. and the community as referent groups. Objective social status was measured using annual family income and years of schooling completed. Gender-specific multivariable linear and logistic regression models were fit to examine associations. Subjective and objective measures were weakly positively correlated. Independent of objective measures, subjective social status was significantly inversely associated with depressive symptoms (men and women) and insulin resistance (women). The associations of subjective social status with the outcomes were modest and generally similar to the objective measures. We did not find evidence that perceived racial discrimination strongly confounded or modified the association of subjective social status with the outcomes. Subjective social status was related to depressive symptoms but not consistently to stress or metabolic risk factors in African Americans.

Subjective social status and health in young people

Health inequalities according to objective socioeconomic position (SEP), have been well-documented. Yet, in young people the associations are negligible. Recently, research on the association of subjective social status (SSS), and adult health has begun to accumulate. Studies on young people are rare and describe societies with large income inequalities. Here, we investigated the association between SSS and health, while controlling for own and familial SEP. The study population consisted of 15-year-olds (N = 2369) who have grown up in a context of low social inequalities. Data were derived from surveys carried out in 2004 in 29 secondary schools in Helsinki. The SSS was measured with an indicator specific to and validated for adolescents (a societal ladder). Outcome measures were self-rated health, health complaints, presence of limiting longstanding illness (LLI) and GHQ-12 caseness (indicating psychiatric morbidity). The SSS associated strongly with all health measures. Adjusting for objective socioeconomic measures attenuated the associations; although they all remained statistically significant apart from LLI among girls. The subjective assessment contributes to health inequalities in young people largely independent of objective SEP. Subjective ratings most probably capture aspects of social hierarchy that are more subtle and less well represented than in conventional measures.