Higher Subjective Social Status Research Articles

Predictors for psychosocial consequences of screening for liver diseases in Germany: a LASSO approach

Abstract Background Medical screening is extensively used across various disciplines for early disease detection and prevention of severe progression aiming to reduce disease-specific burden, improve quality of life and promote health. However, screening is debated due to unclear evidence of its overall benefits from a public health perspective. Screening is associated with improved health behavior and cost-effectiveness. However, studies identified adverse effects of screening like psychosocial burden. Most results originate from cancer screening and it is unclear whether they are transferable to other contexts. Within a research program, a systematic screening procedure to detect patients with liver cirrhosis at early stage in an asymptomatic general population was evaluated. In this study, we aimed to identify patient characteristics that predict and explain variance in psychosocial outcomes of screened patients. Methods This study analyzed data from 523 participants who underwent a systematic liver disease screening in Germany from Jan 2018 to Feb 2021. We used bootstrapped LASSO regression with 10-fold validation to evaluate the influence of various predictors on the outcomes measured by the Psychological Consequences of Screening Questionnaire (PCQ). The constructs measured by the PCQ are social, physical and emotional dysfunction associated with screening. Results We identified lower severity of comorbidities, higher subjective social status, stronger social support, older age, better critical health communication skills and higher health literacy as relevant predictors of lower psychosocial dysfunction, indicating their protective role in preventing psychosocial burden of screening. Conclusions From a public health perspective, medical screening offers should take into account patients’ individual context regarding their subjective social status, health impairments, personal social networks and health literacy skills to reduce post-screening psychosocial burden. Key messages • Social support, age, health literacy and higher subjective social status were positively associated with lower psychosocial consequences of liver screening. • The findings indicate that liver screening should be carried out, taking into account the individual’s situation and resources available.

Associations between perceived discrimination over the life course, subjective social status, and health literacy: A racial/ethnic stratification analysis

ObjectiveTo analyze the relationship between perceived discrimination over the life course, social status, and limited health literacy (HL). Methods5040 adults who participated in the 2023 Survey of Racism and Public Health. We applied stratified multilevel models adjusted for sociodemographic characteristics. ResultsThe average age was 47 years, 48% identified as White, 20% as Latinx, and 17% as Black. In the overall sample, we observed associations of perceived discrimination (b = 0.05, 95% CI: 0.01, 0.09), subjective social status (b = −0.16, 95% CI: −0.23, −0.10), and their interaction (b = 0.02, 95% CI: 0.01, 0.03). More perceived discrimination was associated with lower HL in the White and Multiracial participants. Higher subjective social status was associated with higher HL in the White and Latinx participants. There was a statistically significant interaction between perceived discrimination and subjective social status on HL among the White, Latinx, and Multiracial participants. ConclusionThis analysis has implications for public health practice, indicating that multi-level interventions are needed to address limited HL. InnovationOur findings provide novel insights for identifying key SDOH indicators to assess in clinical settings to provide health literate care.

Subjective social status and socio-demographic correlates of perceived discrimination among older adults in India

BackgroundConsidering India’s diversity, marked by differences in caste, class, ethnicity, religion, region, and language, discrimination can take on varying forms across social-structural locations. We examined the association between subjective social status (SSS) and perceived discrimination, and assessed the sociodemographic correlates of perceived discrimination among older persons in India.MethodsData come from the 2017-18 wave 1 of the Longitudinal Aging Study in India (LASI) with a sample of 30,253 adults 60 years or older. SSS was examined using the Macarthur scale with a ladder technique. Perceived discrimination was evaluated with the Everyday Discrimination Scale. Multivariable logistic regression models examined the odds of reporting discrimination by its types and attributions.Results39% of older adults reported low SSS, whereas 7.3% reported high SSS. Older adults with low SSS had significantly higher odds of experiencing some discrimination than those with high SSS. Compared to high-SSS peers, low-SSS individuals attributed age, gender, caste, financial, and health status as reasons for discrimination. Older women attributed gender as a reason for discrimination. Caste was reported as a reason for discrimination by rural but not urban dwellers. Relative to northerners, those from southern India reported age, financial, and health statuses as reasons for discrimination.ConclusionsThat low-SSS older adults reported age, gender, caste, financial status, and health status as reasons for discrimination and that this association persisted after considering objective indicators of socioeconomic status (SES) is suggestive of SSS as independently consequential for perceived discrimination. These findings are useful for care providers and practitioners as they encourage older patients -- especially those with low SSS who may feel stigmatized -- to seek care, comply with care regimen, and engage in behaviors that protect and promote health.

Decent Work Profiles of Korean Workers: Antecedents and Outcomes of Profile Membership

Recent research has explored profiles of decent work based on the Psychology of Working Theory. However, such investigations have rarely been attempted in Korea. This study applied latent profile analysis to discover decent work profiles and their relationships with antecedents and outcomes. Among 605 Korean workers, five distinct profiles emerged: indecent (7.9%), low safety and healthcare access (34.9%), average (38.1%), decent (13.7%), and value-dominant but low rest (5.4%). Higher subjective social status and work volition were associated with the decent work group, whereas women and individuals with less education were linked to work characterized by greater vulnerability. Furthermore, satisfaction with work needs, job, and life varied significantly across these profiles. The decent work group generally exhibited the highest satisfaction, whereas the indecent work group had the lowest. The low-safety and healthcare access work group tended to exhibit higher satisfaction levels than the indecent work group, but lower levels than the average work group. The v alue-dominant but low-rest work group exhibited life satisfaction comparable to the decent work group. The findings of this study highlight the distinctive characteristics of the working conditions in South Korea. Based on these results, we discuss theoretical and practical implications.

Rural-specific identity and associations with lifestyle behaviors and well-being among rural cancer survivors.

Disparities in rural cancer survivors' health outcomes are well-documented, yet the role of sociocultural aspects of rurality, such as rural identity, attitudes toward rurality, and social standing on health beliefs and behaviors remain unclear. This study aimed to address these gaps. Rural cancer survivors (N=188) completed a mailed/online survey. Regression analyses identified relationships among rural identity, negative attitudes toward rurality, and social standing with health outcomes, quality of life, cancer fatalism, and cancer information overload. Higher rural identity was associated with believing everything causes cancer (OR=1.58, p=0.048), believing "there's not much you can do to lower your chances of getting cancer" (OR=2.22, p=0.002), and higher odds of being overloaded with cancer information (OR=2.05, p =0.008). Negative attitudes toward rurality was linked with higher levels of perceived stress (B=0.83, p=0.001), and chronic pain (OR=1.47, p=0.039). Higher subjective social status was associated with perceived social support (B=0.09, p=0.016), better overall health (B=0.13, p < 0.001), lower levels of perceived stress (B=-0.38, p=0.007), and chronic pain (OR=0.80, p=0.027). Sociocultural factors of rurality were associated with indicators of quality of life, cancer fatalism,and information overload. Further exploration of the underlying mechanisms that drive these associations can help improve intervention targets for rural cancer survivors.

Subjective social status and trajectories of frailty: findings from the English Longitudinal Study of Ageing

ObjectivesSubjective social status is a known antecedent for many health outcomes, but little research has examined the association between subjective status and frailty among older people. Using longitudinal data, the...

Examining factors contributing to the socioeconomic inequalities in handgrip strength among older adults in India: a decomposition analysis

The purpose of this study was to examine (a) the socioeconomic status (SES)-related inequalities associated with handgrip strength (HGS); and (b) the extent to which several demographic, health, and behavioral factors contributed to such SES disparities in HGS among older adults in India. Data were drawn from the 2017–2018 wave 1 of the Longitudinal Ageing Study of India (LASI). The study sample included 27,707 older adults (13,199 men and 14,508 women) aged 60 years and older. HGS was assessed using a handheld Smedley's Hand Dynamometer with a cut-off of 19.5 kg for men and 12.5 kg for women. Bivariate analysis showed the weighted percentage distribution of weak HGS across respondent characteristics. Multivariate logistic regression assessed factors linked to weak HGS. The concentration curve and index (CCI) was used to determine the inequalities in the prevalence of weak HGS by wealth index scores. Wagstaff's decomposition approach was used to test the contribution of each explanatory variable to weak HGS. Around 9% of older adults in this study reported a weak HGS. It was significantly higher among those aged 80 or older (19.21%) and males (15.55%). Weak HGS was concentrated among older adults from poor SES (CCI: 0.05, p < 0.001). A higher percentage of wealth-based inequality in weak HGS was explained by being underweight (38.83%), belonging to the richest wealth quintile (27.95%), and having a higher subjective social status (32.20%). Moreover, about 23.29% of the inequality in weak HGS was explained by Western region and 22.54% by female gender. Additionally, having a secondary level of education explained a higher percentage (22.09%) of inequality, followed by current working status (− 20.68%). Rural residence (13.08%), limitations in instrumental activities of daily living (IADL) (12.21%), and engagement in yoga-related activities (11.55%) explained a higher percentage of wealth-based inequalities. The findings provide evidence of significant SES-related inequalities in HGS and the contribution of various demographic, health, and behavioral factors to such inequality. As such, public health policies and programs focusing on reducing the burden of disability must consider the contribution of social and economic equity to the preservation of muscle strength among older adults.

Transcending Belief: Exploring the Impact of Belief in a Just World on Self-Regulated Learning in Chinese Adolescents Using Latent Transitions Analysis.

While numerous studies have investigated the correlations between Belief in a Just World (BJW) and various variables, research on its stability and changes among different individuals, particularly in China, remains limited. This study aims to identify the classification and trajectories of BJW among Chinese adolescents using a person-oriented approach, including latent profile analysis and latent transition analysis. It also examines the impact of social status on BJW and its influence on self-regulated learning. The longitudinal data were collected from 756 Chinese high school students (35.71% male, Mage = 16.00, age range = 14-19). Three distinct BJW profiles were identified: High-level BJW (~33%), Moderate-level BJW (~51%), and Low-level BJW (~14%). The findings indicate that membership in moderate and high BJW profiles was relatively stable, while the low-level BJW profile showed moderate stability. Higher perceptions of BJW were associated with higher subjective social status. Additionally, students in the High-level BJW profile exhibited the highest levels of self-regulated learning, even after controlling for gender, residence, class cadre, and parental educational levels. These results suggest that subjective social status can enhance Belief in a Just World, which in turn fosters better self-regulated learning skills. The study offers insights into the role of BJW and provides implications for interventions aimed at improving BJW and associated outcomes.

How does subjective social status at school at the age of 15 affect the risk of depressive symptoms at the ages of 18, 21, and 28? A longitudinal study.

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.

ASSOCIATION BETWEEN SUBJECTIVE SOCIAL STATUS AND PHYSICAL FRAILTY AMONG OLDER ADULTS IN INDIA

Abstract Research on the association between subjective social status (SSS) and physical frailty is critical to crafting interventions that can combat functional decline, prolong physical vitality, and sustain quality of life. We assessed the association between SSS and physical frailty and the mediation of this association by perceived everyday discrimination and ill-treatment among older adults in India. Data come from the Longitudinal Aging Study in India with a sample of 31,464 older adults age 60 years and above. Physical frailty was assessed using an adapted version of the frailty phenotype developed by Fried and colleagues. SSS was assessed using the Macarthur scale. Multivariable logistic regression along with KHB (Karlson–Holm–Breen) method was employed to examine the associations and the mediation effects. The prevalence of physical frailty was 30.65% and those with lowest SSS had higher prevalence of physical frailty (42.06%). After adjusting for a number of confounders, odds of physical frailty were significantly lower among those with a high SSS in comparison to those with low SSS, and the variance explained by the SSS was higher than that explained by household consumption quintiles. The association between SSS and physical frailty was mediated by perceived everyday discrimination (percent mediated: 8.20) and experiences of ill-treatment (percent mediated: 9.32). The findings underscore that when examining the association between socioeconomic status and physical frailty, it is important to consider SSS given that perceptions of one’s social standing likely reflect the less apparent psychosocial components associated with it.

Causal effects of point-of-sale cigarette promotions and subjective social status on cigarette craving: a randomised within-person experiment

BackgroundCigarette smoking continues to be a leading cause of preventable deaths in the USA, in part because the USA has not adopted the WHO Framework Convention on Tobacco Control. One...

University students’ willingness to receive a COVID-19 vaccine in the United States

The disproportionate number of COVID-19 cases and deaths in the United States (US) requires understanding of health behaviors that contributed to low acceptance of public health guidelines. University students were at low risk for complications from COVID-19 infections but at high-risk for infecting others. It is important to understand which characteristics influenced willingness to receive the COVID-19 vaccine. The purpose of this cross-sectional study was to explore the social factors and identities that predicted university students’ willingness to receive COVID-19 vaccines before one was available. This study used a stratified random sample from a Midwestern public university in 2020 (N = 614). Results suggest hesitancy toward childhood vaccinations, noncompliance with mask-wearing and large-group-avoidance guidelines, and conservative political ideology increased the odds of being unwilling to receive a COVID-19 vaccination. However, higher subjective social status and male gender increased the odds of being willing to be vaccinated.

Sun protection practices in India: Preliminary findings from a nationally representative sample

Sun safety research has mainly been conducted in the West, whereas little is known about sun protection practices in India. Using a survey design with a representative sample, we aimed to understand the frequency of sun protection practices in India. We also examined associations between demographic covariates and sun safe behaviours. We surveyed a representative sample (N = 1560) from the Indian population in November 2022. The study variables included sun safe behaviours, sunburn experience, demographic information, and skin tone. We employed descriptive and regression analyses to examine the prevalence of behaviours and their associations. To mitigate potential sampling biases, we applied poststratification weights in the analyses. More than half of the participants (64.2%) routinely performed at least one sun safe behaviour, with only 4.9% of the sample reporting no engagement with sun safe behaviours in the last 12 months. Physical protection (e.g., long sleeves, shade/umbrella) were more common than sunscreen use. Regression analysis showed that higher subjective social status, being younger, and living in one of the Eastern Indian states were the strongest predictors of sun protection practices. Our findings fill an important knowledge gap in global sun safe research, highlighting the urgent need for public sun safety education. Scalable and targeted interventions are needed to promote sun safety awareness and practices among people.

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.

Association between subjective social status and physical frailty in older adults in India: perceived discrimination and III-treatment as mediators and moderators.

While extensive research exists on physical frailty, including in low- and middle-income countries like India, studies have yet to appraise whether perceived social standing is associated with physical frailty. As such, this study examines (1) the association between subjective social status (SSS) and physical frailty among older adults in India; and (2) whether this association is mediated and moderated by perceived discrimination and experiences of III-treatment. Data came from the Longitudinal Aging Study in India with a sample of 31,464 older adults aged 60 and above. Physical frailty was assessed using an adapted version of the frailty phenotype developed by Fried and colleagues. SSS was assessed using the Macarthur scale. Multivariable logistic regression models along with Karlson-Holm-Breen (KHB) methodology were employed to examine the direct association, mediational pathways, and the interactions. The prevalence of frailty was 30.65% and those with lowest SSS reported higher prevalence of frailty (42.06%). After adjusting for several confounders, odds of frailty were lower among persons with high SSS relative to those with low SSS, and the variance explained by the SSS was higher than that explained by household consumption quintiles. Moreover, the association between SSS and frailty was mediated and moderated by perceived discrimination and III-treatment. Our findings underscore that when examining the association between socioeconomic status (SES) and physical frailty, it is important to consider SSS given that perceived social status likely reflects the less apparent psychosocial components associated with SES, and that perceived discrimination and III-treatment both mediate and moderate the association between SSS and physical frailty is critical to identifying those older Indians most susceptible to the functional health implications of lower SSS.

Examining individual social status using the MacArthur Scale of Subjective Social Status: Findings from the Born in Bradford study

Subjective social status is how a person perceives their social class relative to other people and has frequently been associated with people's health and well-being. A frequently used measure of subjective social status is the MacArthur Scale of Subjective Social Status that depicts social status as a 10 rung ladder, asking individuals to rank themselves on this ladder relative to other people, either in their local neighbourhood or wider society. The Born in Bradford's Better Start birth cohort study aims to understand the lives, relationships, wellbeing, and social and economic circumstances of pregnant women and their children in three inner city areas of Bradford, UK. Pregnant mothers were asked to report their subjective social status, using the MacArthur subjective social status scales, comparing themselves to other people in their local neighbourhood and in England as a whole. This paper explores the characteristics of the women who gave responses, examines associations between the MacArthur subjective social status measures and other subjective and objective measures and looks specifically at the characteristics of women who reported either very low or very high subjective social status. On average, women reported that they had a higher social status compared to others within their local neighbourhood (mean ladder rung = 6) and, although participants were from areas of Bradford with very high levels of deprivation, 23% placed themselves on the top three rungs, 8–10. Respondents reported that they had an average social status when comparing themselves to people in all of England (mean ladder rung = 5) and 13% placed themselves on the top rungs 8–10. These findings raise important questions about the interpretation of the MacArthur scale of subjective social status.

Gender differences in sense of coherence among university students during the COVID-19 pandemic in Turkey.

Non-pharmaceutical interventions (NPIs) implemented to mitigate the COVID-19 pandemic halted everyday life in higher education along with social and psychological impacts. The objective of our study was to explore the factors related to sense of coherence (SoC) from a gender perspective among university students in Turkey. This is a cross-sectional survey conducted online with a convenience sampling method as part of the international COVID-Health Literacy (COVID-HL) Consortium. SoC was measured by a nine-item questionnaire that was adapted to the Turkish language, including socio-demographic information and health status, including psychological well-being, psychosomatic complaints, and future anxiety (FA). 1595 students from four universities, of whom 72% were female, participated in the study. Cronbach's alpha for the SoC scale was 0.75. Based on the median split of the individual scores, levels of SoC showed no statistically significant difference according to gender. Logistic regression analysis indicated that higher SoC was associated with medium and high subjective social status, studying in private universities, high psychological well-being, low FA, and none/one psychosomatic complaint. While results were similar among female students, type of university and psychological well-being showed no statistically significant association with SoC among males. Our results indicate that structural (subjective social status) and contextual (type of university) factors, along with gender-based variations, are associated with SoC among university students in Turkey.

Does subjective social status affect pain thresholds? – an experimental examination

ABSTRACT Past research regarding the relationship between different constructs of social status and different aspects of pain has yielded divergent results. So far, there are few experimental studies to investigate the causal relationship between social status and pain. Therefore, the present study aimed to examine the effect of perceived social status on pain thresholds by experimentally manipulating participants’ subjective social status (SSS). 51 female undergraduates were randomly assigned to a low- or high-status condition. Participants’ perceived social standing was temporarily elevated (high SSS condition) or reduced (low SSS condition). Before and after experimental manipulation participants’ pressure pain thresholds were assessed. The manipulation check confirmed that participants in the low-status condition reported significantly lower SSS than participants in the high-status condition. A linear mixed model revealed a significant group x time interaction for pain thresholds: Whereas participants’ pain thresholds in the low SSS condition increased post manipulation, pain thresholds of participants in the high SSS condition decreased post manipulation (β = 0.22; 95% CI, 0.002 to 0.432; p < .05). Findings suggest that SSS may have a causal effect on pain thresholds. This effect could either be due to a change in pain perception or a change in pain expression. Future research is needed to determine the mediating factors.

When High Subjective Social Status Becomes a Burden: A Japan-U.S. Comparison of Biological Health Markers.

High subjective social status (SSS) is believed to protect health in the current literature. However, high SSS entails social responsibilities that can be stressful in collectivistic cultural contexts. Here, we tested the hypothesis that those socialized in collectivistic societies (e.g., Japan) recognize their high social status as entailing social duties difficult to ignore even when they are excessive. Using cross-cultural survey data (N = 1,289) and a measure of biological health risk (BHR) by biomarkers of inflammation and cardiovascular malfunction, we found that higher SSS predicted lower BHR for American males. In contrast, higher SSS predicted higher BHR for Japanese males, mediated by the perceived difficulty of disengaging from their current goals. In both cultural groups, females showed no association between SSS and BHR. These findings suggest that social status has differing health implications, depending on the relative salience of privileges and burden-producing responsibilities in different cultural contexts.

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).