Karlson-Holm-Breen Research Articles

The relationship between childhood SES and health in middle and old age: evidence from China.

Drawing from the extended Grossman health capital and demand theory and the life course theory, this study examined whether childhood SES has direct and significant correlation with health in middle and old age in a specific historical context in China. A sample of 9,861 respondents was obtained from the China Health and Retirement Longitudinal Study (CHARLS). Childhood SES was measured by objective indices of recall. Health was assessed by self-reported, physician diagnosis and the Center for Epidemiologic Studies Depression Scale (CESD). The Propensity Score Matching (PSM) was used to estimate the treatment effect between childhood SES and later life health. The Karlson-Holm-Breen (KHB) method was employed to examine the associative mediation effects. Compared to respondents with low SES in childhood, respondents with high SES in childhood had, on average, 5.1% more likely to report their health as good, an average 2.4% lower prevalence of chronic diseases and an average 7.6% lower in the score of depression in middle and old age. The indirect relationships of childhood health, adulthood SES and adulthood lifestyle with health in middle and old age were all significant. SES upward mobility in adulthood can diminish the association between childhood disadvantage and poor health in middle and old age. The health effects of childhood SES can persist into middle and old age, this is more noticeable in rural areas, particularly in females. The critical period, cumulative risk and social mobility models produce synergistic effects in China. Our results also promote a paradigm shift in health interventions from old age to early life for health-vulnerable populations.

Employment uncertainty and parenthood: quantifying the mediating role of union formation

This study aims to quantify the extent to which union formation mediates the relationship between employment uncertainty and the transition to parenthood, taking Italy as a case study. Research on the determinants of low fertility is increasingly shedding light on the negative effects of employment uncertainty. It is generally acknowledged that partnership formation plays a fundamental mediating role, as uncertain employment conditions may hamper the initial formation of a stable union, consequently affecting the likelihood of having a child. Nevertheless, it remains unknown how much of the (total) effect of employment uncertainty on fertility is indeed mediated by union formation. To perform the mediation analysis, we relied on the KHB (Karlson–Holm–Breen) method to accurately assess the effect of employment uncertainty on the transition to parenthood with and without controlling for union formation, i.e. the mediating variable. Results indicate that union formation mediates between 25 and 40% of the negative effect of employment uncertainty on the transition to parenthood, especially among men. Differences by cohort groups are evident, with the youngest cohorts being the most affected by such a mediation. We conclude that union formation is a key element in the relationship between employment uncertainty and fertility as it mediates a non-negligible share of the total effect of employment uncertainty on transition to parenthood.

Association between Multimorbidity and Psychological Distress among Older Adults in India: The Moderating Role of Elder Abuse

ABSTRACT Objectives In this study, we examine the association between multimorbidity and psychological distress and to what extent elder abuse mediates the association. Methods We analyzed cross-sectional nationally representative data from the “Building Knowledge Base on Population Ageing in India (BKPAI).” Multivariate logistic regression was used to understand the association between multimorbidity and psychological distress. We used Karlson–Holm– Breen (KHB) method to understand the role of elder abuse in mediating the association between multimorbidity and psychological distress. Results Older adults who ever experienced abuse (OR = 1.92 95%CI = 1.62, 2.26, p < .001) or in last one month (OR = 2.09 95%CI = 1.65, 2.64, p < .001) reported higher odds of psychological distress. Further, older adults with four or more chronic diseases are thrice more likely to report psychological distress (OR = 3.03 95%CI = 2.38, 3.82, p < .001). The results further suggest the mediating role of abuse on the association between multimorbidity and psychological distress. Conclusions The results suggest the role of elder abuse on the association between multimorbidity and psychological distress among older population in India. Clinical implications Creating an environment to reduce the abuse among older adults who have multimorbidity will be essential to reducing the psychological distress among older adults in India

The Link Between Bullying Victimization and Gun Possession

ABSTRACT Despite a large body of research exploring the influence of adolescent bullying victimization on a range of outcomes such as gun possession, scholars know less about the factors driving these relationships. Grounded in Agnew’s general strain theory, this study investigated whether the influence of bullying victimization on gun carrying behaviors operates indirectly through depressive symptoms. To answer this question, this study used data collected from a statewide representative sample of 9,819 middle and high school students who participated in the 2019 Florida Youth Substance Abuse Survey. Net of other potential confounding influences including race, age, sex, and level of parental education, results from the analyses indicate bullying victimization increased the odds that a respondent carries a gun. When a measure of depressive symptoms was added to the model, however, the bullying victimization variable dropped to non-significance, thus suggesting bullying victimization increased one’s depressive symptoms, which, in turn, increased the odds a respondent carried a gun. Furthermore, results from a Karlson – Holm – Breen (KHB) decomposition analysis revealed this indirect effect was statistically significant. The results from this study provide parents, teachers, and policymakers with information to help address issues associated with bullying and gun carrying behaviors among adolescents.

Medical financial hardship in the Southern United States: the struggle continues across generations pre- and post- the Affordable Care Act

IntroductionMedical financial hardship in the United States is a growing public health concern. This study aims to assess the south vs. non-south disparities in medical financial hardship among US adults of different generations – Boomers (born between 1946 and 1964), Generation X (born between 1965 and 1980), and the Millennials (born between 1981 and 1996) across periods pre- and post- Affordable Care Act (ACA).MethodsThis observational study utilizes data from multiple waves of the National Health Interview Survey (NHIS) split into three periods: pre–ACA (2011–2013), ii) post ACA (2015–2018), and iii) COVID-19 pandemic (2021–2022). Multivariable logistic regressions were fitted, separately for each generation in each period, to compare the extent of medical financial hardship among those from South to rest of the US, and Karlson-Holm-Breen (KHB) decomposition was applied to analyze whether there was a mediating impact of health insurance coverage.ResultsAdults living in the South were more likely to experience medical financial hardship in all three periods. Residing in the South was associated with 1.7 to 2.6% points (pp) higher probability of medical financial hardship among boomers, 1.8 to 4.0 pp among generation Xers, and 1.7 to 2.8 pp among millennials. The relationship was robust after accounting for chronic comorbidities, sociodemographic and socioeconomic attributes and was partially mediated through differences in health insurance coverage.ConclusionsThe problem of medical financial hardship has been deeply rooted in the South across generations, which was partly attributable to the regional differences in health insurance coverage.

Hysterectomy and medical financial hardship among U.S. women

ObjectiveHysterectomy is one of the common surgical procedures for women in the United States. Studies show that hysterectomy is associated with elevated risk of developing chronic conditions, whichmay cause financial toxicity in patients. This study aimed to assess whether women who underwent hysterectomy had a higher risk of experiencing medical financial hardship compared to women who didn’t. MethodsUsing data on 32,823 adult women from the 2019 and 2021 waves of the National Health Interview Survey, we estimated binomial and multinomial logistic regressions to assess the relationship between hysterectomy and financial hardship, defined as problems paying or unable to pay any medical bills. Further, we performed a Karlson-Holm-Breen (KHB) decomposition to examine whether the association could be explained by chronic comorbidity. ResultsWhile the prevalence of financial hardship was 13.6 % among all women, it was 16.2 % among women who underwent a hysterectomy. The adjusted odds of experiencing medical financial hardship among women with a hysterectomy were 1.36 (95 % CI: 1.22–1.52) times that of their counterparts who did not have a hysterectomy. The KHB decomposition suggested that 34.5 % of the size of the effect was attributable to chronic conditions. Women who had a hysterectomy were also 1.45 (95 % CI: 1.26–1.67) times more likely to have unpaid medical debts. ConclusionsOur results suggested that women, who underwent a hysterectomy in the US, were vulnerable to medical financial hardship. Policy makers and health professionals should be made aware of this issue to help women coping against this adversity.

Quality of Student–Faculty Interactions, Persistence, and the Mediating Role of Student Satisfaction

Rising student attrition, exacerbated by the COVID-19 pandemic, has resulted in increased calls for higher education officials to better understand factors associated with increasing persistence rates, especially from the first- to second year of college. Though many studies have documented the influence of the frequency of student–faculty interactions on student persistence, less research has focused on the quality of those interactions, including potential mediating influences. To address these issues, this study used longitudinal data from 8,475 students among 44 four-year institutions to explore whether the quality of student–faculty interactions influences student persistence and whether student satisfaction mediates this relationship. Guided by theoretical models of persistence, we found that even in the presence of a range of potential confounders, students’ perceived quality of student–faculty interactions increased the odds of persistence to the second year of college. Furthermore, results from a Karlson–Holm–Breen (KHB) decomposition analysis suggest this relationship occurred indirectly through students’ satisfaction with the overall college experience.

Racial/Ethnic Differences in Loneliness Among Older Adults: The Role of Income and Education as Mediators.

Loneliness is a major public health concern; however, limited research has examined the mechanisms contributing to racial/ethnic inequities in loneliness. Race/ethnicity has been hypothesized to be a distal factor influencing loneliness, and racial/ethnic inequities in loneliness may be attributable to socioeconomic factors (e.g., income and education). Our study seeks to confirm these hypotheses by examining mechanisms that contribute to racial/ethnic inequities in loneliness. In other words, if racial/ethnic differences in loneliness among older adults are mediated by income and education. Data came from the Health and Retirement Study Leave-Behind Questionnaire, 2014-2016. Loneliness was measured by the UCLA 3-item loneliness scale. Race/ethnicity categories were White, Black, and Hispanic/Latino. The mediator variables were household income and education. Multivariable linear regression models were used to determine differences in loneliness by race/ethnicity. The Karlson-Holm-Breen (KHB) mediation method was used to determine if income and education mediated racial/ethnic differences in loneliness. In models examining income and education together, a complete mediation was found between White and Black older adults, in that income and education completely mediated differences in loneliness between these groups. A partial mediation was found between White and Hispanic, and Black and Hispanic older adults. When examining income and education separately, we found that income solely accounted for racial/ethnic differences in loneliness compared to education. Our study is the first to explicitly determine if socioeconomic factors mediate race/ethnicity differences in loneliness among a national sample of older adults. These findings illustrate that income may have greater proximate effects for loneliness among older adults in comparison to education. Additionally, these findings can inform evidence-based interventions to reduce loneliness among older adults. Interventions that enhance quality of life and provide opportunities for socialization for racialized low-income older adults may help decrease racial/ethnic inequities in loneliness.

Revealing the impact of individual income inequality on different types of charitable giving in China through social interactions

AbstractObjectiveThis study delves into the correlation between individual income inequality as measured by the relative deprivation index and charitable giving, while also examining urban–rural heterogeneity. Additionally, it further explores the mechanisms by which online and offline forms of social interaction operate in this context.MethodsUtilizing data from the 2014–2020 China Family Panel Studies, we employed several methodologies including Probit regression models, cross‐model average marginal effects difference testing based on bootstrap method, instrumental variable method, and the Karlson–Holm–Breen (KHB) effect decomposition method.ResultsThe findings reveal that individual income inequality measured by the relative deprivation index significantly reduces charitable giving among Chinese households. The inhibitory effect of individual income inequality on social charitable giving is higher than that on charitable giving directed toward friends or colleagues. Furthermore, this impact exhibits some heterogeneity between urban and rural areas. Mechanism analysis indicates that the adverse effect of income inequality on charitable giving operates through reducing social interaction, including both online and offline forms.ConclusionOur results demonstrate that income inequality has distinct adverse effects on two types of charitable giving and explain the mechanisms underlying these effects through social interaction. A pattern of the differential mode of association similar to “ripples” in Chinese society is beneficial for understanding these differentiated impacts. We believe it is necessary to improve economic inequality conditions and enhance the enthusiasm of the Chinese public for participating in charitable donations by promoting various forms of social interaction.

Exploring the poverty-reduction benefits of agricultural machinery socialization services in China: Implications for the sustainable development of farmers

Sustainable development is crucial for alleviating poverty among farmers. In this study, we examined the impact, and the mechanism underlying this impact, of the adoption of agricultural machinery services by farmers on their relative poverty from a multidimensional poverty perspective by employing the logit and ordered logit models and the Karlson–Holm–Breen (KHB) method. These results indicate that adopting agricultural machinery services can significantly reduce the probability of relative poverty among farmers, thereby expediting the sustainability of rural development. However, this poverty-reduction effect varies based on age and sex. The adoption of agricultural machinery services mainly reduces poverty by increasing farmers' human capital. Training in employment skills and non-agricultural work experience are the main transmission mechanisms. Therefore, the socialization of agricultural machinery services can be used as an effective policy tool to reduce relative poverty in developing countries, promote sustained improvements in farmers’ incomes, and achieve sustainability in rural development.

Widening Educational Inequalities in Physical Health Due to the Obesity Trend?-A Mediation Analysis Using the German Socio-Economic Panel Study.

This study examined the contribution of obesity to the development of educational inequalities in physical health. We used data from the German Socio-Economic Panel for the period 2002-2020. Physical health was measured with the modified SF12-questionnaire. Logistic regression analyses were applied to estimate time trends. The Relative Index of Inequality (RII) and the Slope Index of Inequality (SII) were calculated to examine educational inequalities. The role of obesity as a mediator was analyzed using the Karlson-Holm-Breen (KHB) method. Over time, educational inequalities in obesity as well as impaired physical health widened in men and women, particularly among those aged 30-49years. For individuals with a low level of education at this age, the probability of impaired physical health increased significantly by 7.7%-points in women and 9.4%-points in men. Of this increase, 25.9% for women and 14.8% for men could be attributed to the increase in obesity. Our findings suggest that the steeper rise in obesity among individuals with a low level of education partly explains the observed widening in educational inequalities in physical health.

The impact of grandparenting on mental health among rural middle-aged and older adults in China: exploring the role of children's support.

In the rural regions of China, characterized by a pronounced aging demographic and limited resources, a substantial proportion of middle-aged and older adults engage in grandparenting roles. Yet, the literature lacks consistent evidence regarding the effects of grandparenting on the mental health of this cohort. Accordingly, this study aimed to explore the impact of grandparenting on the mental health of rural middle-aged and older adults, as well as the underlying mechanisms. This analysis encompassed 10,881 middle-aged and older adults, utilizing data from the 2018 Harmonized China Health and Retirement Longitudinal Study (CHARLS). The mental health of participants was assessed using the Center for Epidemiological Studies Depression-10 (CESD-10) scale, while support from children was categorized into financial and emotional types. The study employed logistic and OLS regression models to identify the mediating role of child support and utilized the Karlson-Holm-Breen (KHB) method for decomposing this mediating effect. The findings demonstrated that grandparenting had a significant negative impact on depression among rural middle-aged and older adults. Furthermore, children's support played a vital role in mediating this relationship, accounting for approximately one-third of the overall influence. Moreover, the decomposition analysis revealed that both emotional and economic support from adult children equally contributed to the declination of depression among rural middle-aged and older adults. Grandparenting significantly enhances mental well-being in rural middle-aged and older adults, with the support from adult children serving as a vital pathway for this positive impact. Both economic and emotional assistance from children hold equal importance in this dynamic. It underscores the necessity of fortifying the family support system to amplify the support provided by children, which in turn could significantly enhance the mental health of rural middle-aged and older adults.

The prevalence of depression, determinants, and linkage with functional disability amongst postmenopausal women in India: Evidence from the Longitudinal Ageing Study in India

BackgroundThe study objective was estimating the prevalence and determinants of depression amongst postmenopausal women in India. Additionally, we used panel mediation analysis to model the extent to which multimorbidity was associated with depression after adjusting for the effects of functional disability in the participants. MethodsData from 28,160 women aged 50 and above from the Longitudinal Aging Study in India (LASI) Wave 1 were analyzed. Depression was assessed using the Composite International Diagnostic Interview-Short Form (CIDI-SF), with multimorbidity and functional disability (ADL and IADL) considered as key predictor variables. Logistic regression and Karlson-Holm-Breen (KHB) mediation analysis were employed. ResultsThe weighted prevalence of depression among women aged ≥ 50 years was 21.76% (95% CI: 20.81, 22.73), significantly higher women aged < 50 years (17.60%, 95% CI: 16.33, 18.94). Factors independently associated with increased odds of depression included being unmarried, rural residence, and multimorbidity, while higher educational status was associated with lower odds of depression. The relationship between multimorbidity and depression was partially mediated by ADL and IADL disabilities. Notable regional (state) variations in the magnitude of depression were observed. ConclusionsNearly one in five postmenopausal women in India aged 50 years and older have clinical depression. Community screening for reaching the unreached with primary care mental health strengthening need enhanced policy focus.

Heritage and hesitancy: how preference for traditional Chinese medicine influences vaccine attitudes.

Vaccine hesitancy, amplified by the COVID-19 pandemic, is a pressing public health challenge. This study investigates the association between Traditional Chinese Medicine (TCM) preference and COVID-19 vaccine hesitancy within China. The study uses data from the 2021 Chinese General Social Survey (CGSS) (N = 2,690). Logistic regressions and Karlson-Holm-Breen (KHB) method are employed to analyzed the relationship between TCM preference and vaccine hesitancy. The study reaffirms prior findings by revealing a robust and stable association between TCM preference and vaccine hesitancy, which remains unaffected by socioeconomic and demographic confounders, as well as institutional trust dynamics of healthcare system. Contrary to expectations, TCM enthusiasts do not exhibit vaccine hesitancy based on divergent epistemological views concerning vaccine risks and immunity acquisition compared to biomedicine. This research enriches understandings of the intricate relations between healthcare paradigms and vaccine attitudes, inviting further inquiry into the role of CAM in shaping vaccination behaviors across different cultures and contexts. The insights bear significant public health implications for enhancing vaccine acceptance and coverage, particularly among populations where CAM practices wield substantial influence.

Effect of health rights accessibility on the urban integration of minority rural migrants in China: a cross-sectional study

BackgroundAccessing health rights is an integral component of people’s aspirations for a better life. Existing discussions and evaluations regarding the accessibility of health rights for minority rural migrants are insufficient. In comparison to objective health conditions, inequalities in health rights lead to chronic and long-term depletion of human capital among minority rural migrants. This study aimed to assess the overall impact, heterogeneity effects, and mechanisms of health rights accessibility on the urban integration of minority rural migrants.MethodsBased on the 2017 China Migrants Dynamic Survey Data (CMDS), this study employs OLS models, 2SLS models, conditional mixed process (CMP) methods, and omitted variable tests to estimate the impact of health rights accessibility on the urban integration of minority rural migrants. Additionally, from the perspectives of migration scope and illness experience, this study explored the heterogeneity in the relationship between health rights accessibility and urban integration. Finally, using the Karlson–Holm–Breen (KHB) model, this study dissects the mechanisms through which health rights accessibility influences the urban integration of minority rural migrants.ResultsHealth rights accessibility significantly enhances the urban integration of minority rural migrants. Moreover, compared to minority rural migrants who move across provinces and who have no history of illness, those who migrate within the same province and who have experienced illness are more sensitive to the positive impact of health rights accessibility. However, the enhancing effect of health rights accessibility does not significantly differ between the new and old generations of minority rural migrants. Furthermore, health rights accessibility can indirectly improve the urban integration of minority rural migrants by elevating health levels, improving health habits, and reinforcing health behaviors. Among these, the indirect effects mediated by health habits are more pronounced.ConclusionThe research conclusions underscore the issue of health accessibility and urban integration among minority rural migrants, providing a reexamination and clarification of the policy effects of health rights in promoting the urban integration of minority rural migrants. Relevant policy design should commence with improving the health rights of minority rural migrants, enhancing their health integration capabilities, and effectively boosting their ability to integrate into urban life.

Modifiable risk factors of inequalities in hypertension: analysis of 100 million health checkups recipients.

Inequalities in health behaviors are thought to contribute to inequalities in hypertension. This study examined the extent to which modifiable mediating factors explain income inequalities in hypertension. This repeated cross-sectional study used data from National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) from 2009 to 2015. Those aged between 40 and 74 were enrollees in the Specific Health Checkups. Hypertension was defined as systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90, or the use of antihypertensive medication. The mediating effects of exercise, obesity, smoking, and alcohol drinking on the association between income, as an indicator of SES, and hypertension were determined by the Karlson-Holm-Breen (KHB) method. The mean age of the 68,684,025 men and 59,118,221 women was 54.7 (SD = 9.6) and 56.7 (SD = 10.0) years, respectively. Prevalence of hypertension was higher in the lowest income group (48.6% for men, 40.2% for women) than in the highest income group (33.3% for men, 21.5% for women). Inequalities tended to increase over time. Inequalities were larger among those who did not use antihypertensive medication. Modifiable risks explained 10.6% of the association between income and hypertension for men and 15.1% for women. In men, drinking and obesity explained 8.8% and 5.5% of the inequalities in hypertension, respectively. In women, obesity explained 18.8%. Exercise increased the proportion mediated over time. Smoking explained 5.5% among women taking antihypertensive medication. There were health inequalities in hypertension among Japanese adults, and the modifiable risk factors partially explained the inequalities.

Education and pandemic SARS-CoV-2 infections in the German working population - the mediating role of working from home.

SARS-CoV-2 infections were unequally distributed during the pandemic, with those in disadvantaged socioeconomic positions being at higher risk. Little is known about the underlying mechanism of this association. This study assessed to what extent educational differences in SARS-CoV-2 infections were mediated by working from home. We used data of the German working population derived from the seroepidemiological study "Corona Monitoring Nationwide - Wave 2 (RKI-SOEP-2)" (N=6826). Infections were assessed by seropositivity against SARS-CoV-2 antigens and self-reports of previous PCR-confirmed infections from the beginning of the pandemic until study participation (November 2021 - February 2022). The frequency of working from home was assessed between May 2021 and January 2022.We used the Karlson-Holm-Breen (KHB) method to decompose the effect of education on SARS-CoV-2 infections. Individuals with lower educational attainment had a higher risk for SARS-CoV-2 infection (adjusted prevalence ratio of low versus very high = 1.76, 95% confidence interval 1.08-2.88; P=0.023). Depending on the level of education, between 27% (high education) and 58% (low education) of the differences in infection were mediated by the frequency of working from home. Working from home could prevent SARS-CoV-2 infections and contribute to the explanation of socioeconomic inequalities in infection risks. Wherever possible, additional capacities to work remotely, particularly for occupations that require lower educational attainment, should be considered as an important measure of pandemic preparedness. Limitations of this study are the observational cross-sectional design and that the temporal order between infection and working from home remained unclear.

Foster care experiences during childhood and health during older age: Evidence from China.

Improving the health of older individuals is the primary approach to dealing with the challenges of an aging population. Experiences during childhood can have a continual influence on individual health conditions. Consequently, understanding whether foster care experiences during childhood influence an individual's health during older age is relevant. Data from the China Health and Retirement Longitudinal Study, 2014, were collected. The influence of foster care experiences during childhood on health during older age was analyzed using the least-squares method. The mediating effects of childhood health status, education opportunities, and nutritional level were analyzed using the Karlson-Holm-Breen (KHB) method. Foster care experience during childhood was associated with reduced self-rated health status during older age due to adverse effects on (a) childhood health status, (b) childhood education opportunities, and (c) childhood nutritional level. The influences of early life factors on the health status of older adults should be analyzed from the perspective of the lifecycle to provide positive interventions for health improvement. The outcomes from such a study could help to improve the health condition of elderly citizens. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A study on Internet use and subjective well-being among Chinese older adults: based on CGSS (2012-2018) five-wave mixed interface survey data.

This study is designed to investigate the relationship between Internet use and subjective well-being of the older adults in China, and to analyze the mediating role of subjective social fairness in the above relationship. Based on the five-wave mixed interface survey data of China General Social Survey (CGSS) in 2012, 2013, 2015, 2017, and 2018, we select a total of 18,458 older adults aged 60 and above, and comprehensively used ordered probit regression, propensity score matching (PSM), and Karlson-Holm-Breen (KHB) mediating effect test methods. The analysis results show that (1) Internet use is significantly positively correlated with the subjective well-being of the older adults, and the higher the frequency of use, the stronger the subjective well-being. (2) Place of residence, education, and regional factors moderated the effect of Internet use on subjective well-being. The subjective well-being effect of Internet use is significant among male older adults, as well as on urban, educated, or eastern older adults. (3) Subjective social fairness plays a negative mediating role in the relationship between Internet use and subjective well-being of older adults. The findings suggest that Internet use contributes to the improvement of subjective well-being in older adults, but attenuates this effect by reducing the subjective social fairness. Future research should further consider other factors such as the purpose, specific function, intensity of Internet use, etc., to gain a deeper understanding of how the Internet can help promote well-being.

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.