Objective Socioeconomic Status Research Articles

The impact of family socioeconomic status on depression in Chinese adolescents: A comparison of life course models

BackgroundLow socioeconomic status (SES) is a well-recognized risk factor for depression. However, the relationship between the timing of exposure to disadvantaged SES in childhood and depression in adolescence remains to be explored. We examined the differential influence of SES in early childhood, late childhood and adolescence on adolescent depression by modeling life course models. MethodsWe used longitudinal data from the China Family Panel Studies (N = 2245). SES was measured using average household income (objective SES) and maternal subjective SES and grouped into three time points: 5–8 years, 9–12 years, and 13–16 years of age. The main outcome was depression at 13–16 years of age. Structured linear regression analysis was used to predict depression by low SES over the three time periods. A partial F test was used to compare the nested life course models to the saturated model. ResultsAmong objective SES permutations, approximately 24.63 % of the adolescents had low SES in all periods, and 73.63 % had low SES in at least one period. Among subjective SES permutations, approximately 5.48 % of the adolescents had low SES in all periods, and 54.65 % had low SES in at least one period. Regardless of objective SES or subjective SES, the accumulation of risk (relaxed) model was the best-fit model. In this model, chronic low SES exposure in late childhood was the best predictor. ConclusionWe suggest that interventions targeting the late childhood period may have a practical effect on reducing depression in adolescents.

Migrants Subjective Well-being in Big Cities of China: Based on Self-rating Social Status and Social Integration

Promoting subject well-being of migrants could give full play to the advantages of talent's resource. Social position and social inclusion of migrants could be the key to pursue a people-centered, new type of urbanization and bring about rural migrants settling in cities. There is a lack of studies focusing on social comparison and social inclusion of migrants with the point of geographical features. Using the data collected from China Migrants Dynamic Survey in 2014, the relations among object socioeconomic status and self-rating social status as well as subject well-being of migrants in one municipal district and seven prefecture-level cities of China was examined by adopting multilevel linear regression model, which includes both mediating variables and moderating variables. Several conclusions are drawn as follows: 1) Migrants subjective well-being is affected by their objective socioeconomic status. Whilst migrants comparing themselves with local relatives and colleagues, as we call it self-rating social status, plays a part in mediating relations between object socioeconomic status and subject well-being, especially when the object socioeconomic status refers to migrants household monthly income, certain types of occupations (including civil servants, clerks and the self-rated) and homeowners in the host city. 2) When compared their socioeconomic status with locals in the host cities, including economic status and respect for themselves, the deeper the migrants are merging into cities and social networks, the weaker the relationship between self-rating social status and subjective well-being will be. In other words, social inclusion among migrants do negatively regulates the relations above. 3) However, there is no evidence that the higher the acceptance degree of local residents in host cities to migrants, the deeper the impact of the respect for migrants on subjective well-being will be. Obviously, the acceptance degree of local residents could not significantly moderate the relations between respect for migrants and their subject well-being. Based on the above research conclusions, this paper suggests that for building a harmonious society and improving the quality of urbanization, equal treatment of migrants and locals should be identified and dealt with. Furthermore, Therefore, we must speed up migrants to blend into the society in the cities.

Social class stigma and poorer health behaviors: Evidence from the eating in America study

Although the association between objective markers of low socioeconomic status (SES) and poor health is well established, one underexamined possibility is that over and above objective SES, social class stigma—experiences and anticipation of discrimination based on social class—might undermine people's ability to engage in healthy behaviors. Participants (N = 2022) were recruited between December 2019 and January 2020 via a national Qualtrics panel that was census-matched to the U.S. population in age, gender, income, race/ethnicity, and census region. Participants completed measures of class stigma, alcohol use, disordered eating, comfort eating, sleep disturbance, physical activity, and demographics. Controlling for objective SES and demographics, generalized linear regression models indicated that class stigma was associated with significantly greater alcohol use, disordered eating, greater comfort eating, and sleep disturbance but not less physical activity. Class stigma was not associated with health behaviors after full adjustment for weight/racial discrimination and psychological factors. Results from this investigation suggest that beyond one's objective SES, the stigma associated with having low class may also contribute to poorer health behaviors.

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...

Perceived Social Exclusion Partially Accounts for Social Status Effects on Subjective Well-Being: A Comparative Study of Japan, Germany, and the United States

People who are socioeconomically better off tend to report higher levels of well-being, with inconsistent roles ascribed to objective socioeconomic status (SES), subjective SES (SSES), and personal relative deprivation (PRD)—depending on the predictors, facets of well-being, and countries under study. We tested a comprehensive model of social status indicators as determinants of subjective well-being by a) including PRD, SSES, income, and education as predictors, b) assessing subjective well-being as well as interdependent happiness (happiness in relation to significant others), c) testing the model in Japan, Germany, and the US—countries with comparable societal structure (e.g., educated, industrialized, rich, democratic) but diverging cultural dimensions, and d) testing an explanatory variable: feeling excluded from society. Cross-culturally (N = 2,155), PRD and SSES independently and strongly predicted well-being, while income and education exhibited negligible direct effects. SSES emerged as the predominant predictor in Japan compared to the US and Germany, whereas PRD was the predominant predictor in the US compared to Germany and, to a lesser extent, Japan. This was largely accounted for by culture-specific links of social status with perceived social exclusion—the extent to which people feel unable to keep up with society as a whole. Perceived social exclusion was more strongly linked to SSES in Japan compared to Germany and the US, and more strongly linked to PRD in the US than in Germany. The role of perceived social exclusion as an explanatory variable in the relationship between social status and subjective well-being merits further investigation within and between countries.

Independent and Interactive Associations of Subjective and Objective Socioeconomic Status With Body Composition and Parent-Reported Hyperphagia Among Children.

Background: Subjective socioeconomic status (SSES) and objective socioeconomic status (OSES) have been independently associated with body composition and eating behavior in children. While low OSES may constrain access to healthier foods, low SSES has been associated with increased preference for and motivation to consume higher energy foods and portions independent of OSES. Despite these distinct ways that OSES and SSES may affect children's eating behavior and adiposity, their joint contributions remain unclear. We investigated the independent and interactive associations of SSES and OSES with children's BMI, fat mass index (FMI), and caregiver-reported hyperphagia. Methods: Data were derived from the Children's Growth and Behavior Study, an ongoing observational study. Multiple linear regressions used child's SSES and OSES of the family as independent factors and modeled the statistical interaction of SSES and OSES with BMI (n = 128), FMI (n = 122), and hyperphagia and its subscales (n = 76) as dependent variables. Results: SSES was independently and negatively associated with hyperphagia severity and OSES was independently and negatively associated with both FMI and hyperphagia severity. There was a statistical interaction effect of SSES and OSES on hyperphagia severity-lower SSES was associated with greater hyperphagia severity only at lower levels of OSES. Conclusions: These findings demonstrate a relationship between low OSES and child adiposity and that the relationship between child SSES and hyperphagia severity may be most relevant for children from households with lower family OSES. Future research on socioeconomic disparities in children's body composition and eating behaviors should examine the interaction of SSES and OSES. Clinical Trial Registration: NCT02390765.

15 Does Subjective Socioeconomic Status Mediate the Relationship Between Objective Socioeconomic Status and Neuropsychological Test Performance Across Race and Ethnicity?

Objective:Socioeconomic disadvantage is a chronic stressor associated with several biological markers of health (e.g., inflammation) as well as early-onset cognitive aging. Studies examining socioeconomic status (SES) and its link with health outcomes exhibit no uniformity in the way in which SES is measured and defined. Also, studies have found that subjective socioeconomic status (SSES), defined by a subjective SES scale, was more consistently and strongly related to psychological functioning and health-related outcomes than objective socioeconomic status (OSES), defined by a composite score of education, household income, and occupation. The goal of the current study was to assess whether SSES mediates the relationship between OSES and neuropsychological test performance similarly across racial and ethnic groups.Participants and Methods:Participants were 1,912 middle-aged older adults (13% non-Hispanic white, 17% non-Hispanic Black, 69% Hispanic/Latinx) from the Offspring study. Participants are the adult children of participants in the Washington Heights Inwood Columbia Aging Project, a community-based cohort study of aging and dementia representing the ethnic/racial diversity of upper Manhattan. Participants on average were 56.5 years of age and 67% were women. Measures of verbal learning and memory (SRT immediate and delayed recall), verbal fluency (animal and letter fluency), and attention/working memory (digit span forward and backward) were administered. OSES was characterized by years of formal education completed. SSES was measured by the MacArthur Scale of Subjective Social Status. The scale measures perceptions of one’s social standing relative to others. We conducted separate stratified mediation analyses for each neuropsychological outcome across each racial and ethnic group. All models were adjusted for age.Results:Participants with higher OSES demonstrated higher neuropsychological test scores (effect size associations ranged from .29 to .45) and reported higher SSES (b=.109 95% CI: .08, .14). Lower SSES was associated with lower neuropsychological test scores (effect-size range .06 to .13). In stratified analyses, the relationship between OSES and SSES was strongest for White participants (b=.13 [.01, .24]) compared with Latinx (b=.06 [.02, .11]) and Black (b=.06 [-.03, .16]) participants. Associations between SSES and neuropsychological outcomes were only reliable for White participants on SRT Immediate and Delayed Recall and Animal Fluency and for Black participants on Digit Span Forward. In mediation analyses, SSES mediated the relationship between OSES and Immediate Recall (indirect effect b=.18 [.001, .45]; 39% mediated), Delayed Recall (indirect effect b=.05 [.004, .09]; 44% mediated), and Animal Fluency (indirect effect b=.09 [.01, .20]; 22% mediated) for White participants. There was no evidence of mediation in Black or Latinx participants.Conclusions:The relationship between OSES and SSES was strongest for White participants compared to Black and Latinx participants. Even though perception of social status predicted lower cognitive test scores among Black and Latinx adults, it is only a part of the indirect pathway linking OSES to cognitive function among White adults. It is likely that mechanisms related to tangible resources that benefit health (as opposed to perceived inequity) are in the pathway linking education to cognition among Black and Latinx, and thus intervening on systems of inequality throughout the life course has the most promise for improving brain health in those communities.

Effect of subjective and objective socioeconomic status on physical health, mental health, and well-being

We investigated the independent and interactive effects of subjective socioeconomic status and objective socioeconomic status on physical health, mental health, and well-being. We collected questionnaires from 276 adults in China. Results showed that subjective socioeconomic status and objective socioeconomic status were positively related to mental health, physical health, and well-being. In addition, there was an interactive effect of subjective socioeconomic status and objective socioeconomic status on well-being. These findings provide a deeper understanding of the mechanisms by which socioeconomic status affects health and well-being and suggest that we should begin to improve peopleâ–™s well-being by looking at individual socioeconomic status.

Subjective social status and functional and mobility impairments among older adults: life satisfaction and depression as mediators and moderators

BackgroundWhile functional and mobility impairments (FMIs) have garnered the attention of health researchers in low and middle-income countries (LMICs), including India, research has yet to explore whether and to what extent the perception of one’s social status is associated with FMIs. We fill this gap in the literature by examining (1) the association between subjective social status (SSS) and FMIs among older adults in India and (2) whether this association between SSS and FMIs is mediated and moderated by life satisfaction and depression.MethodsData come from the 2017-18 wave 1 of the Longitudinal Aging Study in India (LASI) with a sample of 31,464 older adults aged 60 years and above. FMIs were assessed using established scales on impairments in activities of daily living (ADLs), instrumental activities of daily living (IADLs), and mobility. SSS was assessed using the Macarthur scale. Life satisfaction was measured using responses to five statements gauging respondent’s overall satisfaction with life. Depression was calculated using the shortened version of the Composite International Diagnostic Interview (CIDI-SF). Multivariable regression was employed to examine the association between variables, and the interaction terms and Karlson-Holm-Breen (KHB) method were used separately to test the mediation and moderation effects.Results39.11% of the sample had a low SSS, 8.26% were depressed, and 32.07% reported low life satisfaction. A total of 8.74%, 10.91%, and 8.45% of the study population reported at least one impairment in ADL, IADL, and mobility, respectively. Older adults in the higher SSS group were less likely to have ADL impairment (beta: -0.017, CI: -0.030, -0.0032) and mobility impairment (beta: -0.044, CI: -0.076, -0.013). Depression moderated the association between SSS and mobility impairment (p-value: 0.025), and life satisfaction moderated the association between SSS and ADL impairments (p-value: 0.041) and SSS and IADL impairments (p-value: 0.037). Depression mediated 20.28%, 31.88%, and 18.39% of the associations of SSS with ADL, IADL, and mobility impairments, respectively. Similarly, life satisfaction mediated 23.24%, 52.69%, and 27.22% of the associations of SSS with ADL, IADL, and mobility impairments.ConclusionsThat SSS is associated with FMIs among older Indians, even after considering their objective socioeconomic status (SES), suggests that the use of SSS is relevant to the study of health inequalities in India. The finding that life satisfaction and depression mediate and moderate this association is crucial in pinpointing those older Indians at risk of the functional and mobility-related repercussions of lower SSS.

Subjective Social Status and Longitudinal Changes in Systemic Inflammation.

Subjective social status (SSS) refers to a person's perception of their social rank relative to others and is cross-sectionally linked to systemic inflammation independently of objective socioeconomic status. We test the extent to which SSS relates to multiyear changes in inflammation, or if associations differ by race or sex. Healthy adults (N = 331; 30-51 years) completed a baseline visit and 278 participants returned for a second visit 2.85 years later. At both visits, participants underwent a fasting blood draw and completed community (SSSC) and US (SSSUS) versions of the MacArthur Scale. Multiple linear regression analyses examined change in interleukin-6 (IL-6) and C-reactive protein (CRP) predicted by each type of SSS, adjusting for time between visits, sex, race, age, body mass index, smoking, baseline inflammation, and objective socioeconomic status. Additional analyses further adjusted for hopelessness and depressive symptoms. Interactions examined moderations by sex and race. Lower SSSC was longitudinally associated with greater IL-6 independently of all covariates, including education and income (β = -0.06), hopelessness (β = -0.06), and depressive symptoms (β = -0.06). Lower SSSUS was longitudinally associated with greater IL-6 independently of demographic covariates including education and income (β = -0.06), but was slightly attenuated after adjusting for hopelessness (β = -0.06) and depressive symptoms (β = -0.06). There were no associations for CRP or moderation by race or sex. Lower SSS may be associated with greater circulating markers of inflammation over time as suggested by increases in IL-6.

Ambition or comparison? Socioeconomic status and wellbeing differences between local and migrant workers.

Pursuing wellbeing is an essential part of human life and plays a determining role in public health and social sustainability. Prior research identified objective socioeconomic status (O-SES), such as real income and homeownership, as facilitators of human subjective wellbeing (SWB). However, not all humans with better SES reported high SWB. This paper expects that subjective socioeconomic status (S-SES) is the key path through which O-SES shapes SWB and that this indirect relationship varies by household registration status, length of residentship, and type of migrant status. Based on a national representative survey dataset-China General Social Survey 2010 (CGSS), the results of generalized structural equation modeling (GSEM) show that household income and homeownership as O-SES are positively related to SWB. Self-evaluated household SES as an important indicator of S-SES not only has a positive relationship with SWB but also significantly mediates the relationship between O-SES and SWB, especially for the new-local residents (NLRs), urban-to-urban migrants (UUMs) and rural-to-urban migrants (RUMs). This study has substantial implications for targeting the comparative psychology and sustainable productivity of Chinese migrants and the local labor force since it is currently facing a growing aging society.

The different effects of income and educational level on prosocial behaviour and related ideological variables (Los diversos efectos del nivel de ingresos y nivel educativo en la conducta prosocial y otras variables ideológicas relacionadas)

ABSTRACT Studies on socioeconomic status (SES) have recently increased in social psychology. The most used indicators to measure objective SES are income and educational level (usually standardizing and summing the scores of these variables). However, income and education possibly have different, even opposite effects on certain variables. Across seven studies, using data from previous research and from international databases, we show that this is true both for prosocial behaviour and for variables related to prosocial behaviour. A higher educational level tends to positively predict prosocial behaviour (Studies 1a–1d) and structural attributions of poverty (Studies 2 and 3), and negatively predict scores for meritocratic beliefs (Study 3) and just world beliefs (Study 4). In most cases, income showed a reverse trend or did not predict the outcome. We discuss the broader implications both for the study of prosocial behaviour and social class.

Association and potential mediators between socioeconomic status and childhood obesity in China: findings from a national cohort study

ObjectiveSocioeconomic status (SES) is associated with childhood obesity, but the underlying factors remain unknown. This study aimed to identify mediators that may explain SES disparities in childhood obesity in China. MethodsNationally representative longitudinal data from the China Education Panel Survey of 11 019 children (13.03 ± 0.79) collected from 2013‒2014 to 2016‒2017 academic years. Overweight/obesity was defined using Chinese national body mass index cut-points. Principal component analysis was used to convert the four SES indicators (maternal and paternal education, and occupation) into one comprehensive variable. Mediation analysis for SES disparities in childhood obesity was conducted using structure equation models. ResultsThe prevalence of overweight/obesity was 12.8%, and was higher in boys than in girls (17.8% vs. 7.6%, P < 0.001) at baseline. Among boys, relative risk (RR) of obesity was 1.23 (95% CI: 1.09 to 1.40, P < 0.001) for per unit change in SES. There was no significant association between obesity and SES among girls. Mediation analyses showed that among boys, birth weight, being the only child in the family and children's self-perceived weight status mediated 70.0% of the effects of SES on obesity. No mediation effect was detected in girls. ConclusionsChinese boys are more likely to be overweight or obese than girls. SES may impact childhood obesity through birth weight, being the only child in the family and children's self-perceived body weight status in boys, but not in girls. More attention should be made to address childhood obesity in high SES families among boys. Interventions targeting at these mediators are needed.

Subjective Socioeconomic Status in Small-Scale Aquaculture: Evidence from Central-Southern Chile

Socioeconomic status (SES) is a multidimensional concept that involves objective markers, such as income, education, and occupation, along with subjective data, which indicate how people perceive their socioeconomic position. Gaps and the lack of linear relationships in objective SES data have supported the need to include subjective markers. This study evaluates the effect of certain critical predictors on the subjective SES of small-scale aquaculture producers in Central-Southern Chile, addressing a gap in research. We explore the impact of income, education, occupational settings, social capital, and subjective health status on self-reports of current and future subjective socioeconomic status. We use primary data collected through a government-funded project. The fieldwork included a face-to-face survey implemented between February and March 2017 with 225 participants, all located in the Bio-Bio or Lagos regions of Chile. Bi-probit regression models were applied to test how the current and future subjective SES is affected by the following variables: engaging small-scale aquaculture production, having a secondary occupation, harvesting two or more different resources, maintaining extended social networks to cope with economic problems, subjective health status, average monthly income from aquaculture or fishery, perceptions about how difficult it is to find alternative work, and education as means for personal and occupational development. The results show that engaging in small-scale aquaculture positively affects current and future subjective socioeconomic status. Income is a robust predictor of present and future socioeconomic status. Education loses relevance on subjective SES later in life, whereas social capital gains importance.

Subjective Socioeconomic Status Moderates Self-Esteem Reactivity to Daily Stressor Exposure: Evidence From a Daily Diary Approach.

Research on self-esteem reactivity has demonstrated that self-esteem fluctuates in response to daily stressor exposure, and the strength of this relationship varies between individuals. Drawing upon the positive link between objective socioeconomic status (SES) and self-esteem, how subjective SES influences self-esteem reactivity to daily stressor exposure was explored. Using a 7-day daily diary study, the current study (Nparticipants = 243, Ndays = 1651) adopted a multilevel analysis to demonstrate that subjective SES attenuated the within-person association between daily stressor exposure and daily self-esteem, even after controlling for demographics and objective indicators of SES. The interactions were also consistent across social stressors and non-social stressors. The findings provide evidence supporting the protective role of subjective SES in self-esteem reactivity to daily stressor exposure.

Subjective economic inequality is associated with lower well-being through more upward comparison and lower trust.

Individuals often misconstrue the actual degree of economic inequality, which might account for the ambiguity in the literature about the role that inequality plays in well-being. Instead of focusing on objective inequality, we propose a subjective inequality approach by investigating the long-term association between subjective economic inequality and well-being (N = 613). We found that subjective inequality predicted lower life satisfaction and higher depression one year later, which were accounted for by more upward socioeconomic comparison and lower trust. Furthermore, the negative association between subjective inequality and well-being remained constant, regardless of individuals' objective socioeconomic status (SES), subjective SES, and mindset of SES. The long-term association between subjective inequality and well-being remained robust after controlling for prior levels of well-being and multiple covariates. Our findings revealed that subjective inequality is detrimental to well-being and opens a new window into psychological research on economic inequality.

Indirect effect of race-related stress on traumatic stress and depression symptoms via subjective social status in a Black community sample.

Experiencing racism is linked to lower subjective social status (SSS), defined as one's perception of their position in society. SSS is influenced by power, prestige, and objective socioeconomic status (SES). Previous findings suggest that race-related stress may be related to adverse mental health outcomes through SSS in Black Americans, a population that has been deeply affected by continuing legacies of oppression. The current study examines the indirect association between race-related stress and posttraumatic stress disorder (PTSD) and depression symptoms through SSS in a community sample of largely trauma-exposed Black Americans (N = 173). Hierarchical regression analyses indicated that overall race-related stress significantly predicted lower SSS, higher PTSD symptoms, and higher depression symptoms. Analyses also revealed indirect effects of cultural race-related stress on PTSD and depression symptoms through SSS after controlling for SES. Results suggest that the experience of race-related stress, particularly cultural race-related stress, which involves the degradation and disparagement of one's culture and worldview, is associated with more severe PTSD and depression symptoms potentially due to these experiences decreasing Black Americans' SSS. Findings support the need for systemic intervention strategies to disrupt the cultural oppression of Black Americans and improve the societal value and mental health of this population.

P106 Hidradenitis suppurativa is associated with lower socioeconomic status using the MacArthur scale of subjective social status

Abstract Hidradenitis suppurativa (HS) is associated with lower socioeconomic status (SES). Previous studies in Europe, Australia and the USA identified that patients with HS are more likely to be unemployed and have lower mean incomes than the background population. Low SES is inextricably linked with poor health outcomes. The MacArthur scale of subjective social status is a simple ladder from 1 to 10 that describes perceived SES and is an even better predictor of health outcomes than objective measures of SES. Our aim was to evaluate SES in HS using the MacArthur scale and compare it with healthy controls. Patient recruitment took place in two dermatology clinics where all patients with HS were invited to participate in addition to an anonymous online survey distributed by HS patient-led organizations. Healthy control patients were recruited from a rapid-access lesion clinic. Statistical analysis was completed using Jamovi (version 2.0). Student’s t-test was used to compare means and Spearman’s test for correlation. We recruited 131 patients with HS with a mean age of 37.6 years and 82 healthy controls with a mean age of 48.7 years. Patients with HS were predominantly female (89.3%) as were healthy controls (62.2%). The mean (SD) MacArthur scale in the HS group was 4.85 (2.19) (range 1–10). It was higher in healthy control patients at 6.44 (1.36) (range 3–10; P &amp;lt; 0.001). In the HS cohort, the mean MacArthur scale was higher in employed patients (5.49 vs. 3.59; P &amp;lt; 0.001) and in patients who completed any education following school (5.19 vs. 4.12; P = 0.009). The MacArthur scale weakly but statistically significantly correlated with age (r = 0.158, P = 0.022) and was higher in male patients (6.14 vs. 5.27; P = 0.013). Owing to the influence of age and sex on the MacArthur scale, a group of 37 patients with HS with age- and sex-matched healthy controls was analysed. In this matched group, the mean MacArthur scale was lower in patients with HS (5.22 vs. 6.36; P = 0.018). This is the first study to assess SES in HS using the MacArthur scale of the subjective social status. Patients with HS had a significantly lower SES than healthy controls. The MacArthur scale accounted for both employment and education in the HS cohort. The ladder is easy to use and provides more information with regard to health outcomes than objective SES alone. Its use should be considered in HS research, particularly studies evaluating treatment response, disease and comorbidity outcomes.

Parental Objective, Subjective, and Contextual Socioeconomic Status and Children's Mental Health in Iran: The Mediating Effect of the Subjective Measure

Background: Children from lower socioeconomic status (SES) households are at greater risk for mental illnesses. Socioeconomic status has different dimensions: Objective SES, subjective SES, and contextual SES. Evidence suggests that subjective SES partially mediates the impact of objective SES on mental health. However, these hypotheses have not been tested in Middle Eastern cultures, including Iran. Objectives: We aimed to investigate: (1) if there is an association between parental objective, subjective, and contextual SES measures and their children's mental health in a network of general practitioners' clients, (2) if such an association exists for objective or contextual indicators, is it partially or fully mediated through subjective measure? and (3) if such an association exists, is it affected by children's age? Methods: We assessed 1,103 parent-child pairs in the general practitioners' network of clients. The child's mental health was assessed by the Strengths and Difficulties Questionnaire (SDQ) and parental objective SES by education level, subjective SES by the MacArthur scale, and contextual SES by the household neighborhood. Linear regression models were used to investigate the impact of different SES measures on the SDQ score both bivariately and adjusted for each other. A mediation analysis was performed for objective SES' indirect effect on SDQ score through subjective SES. Results: We found a significant association between objective and subjective SES and the SDQ score, which remained significant after adjusting for each other. Both objective and subjective measures had a small effect size (Cohen's f-squared = 0.03). There was no association between contextual SES and SDQ scores in our sample. Conclusions: Socioeconomic status impacts children and adolescents' mental health. However, SES is a multi-dimensional concept. Further research considering different dimensions is needed to understand the interplay of these dimensions in different cultures and contexts. Addressing such exploratory questions may help pave the way for detecting and addressing these social determinants in primary care settings.

Subjective socioeconomic status: an alternative to objective socioeconomic status

BackgroundSubjective “ladder” measurements of socio-economic status (SES) are easy-to-administer tools that ask respondents to rate their own SES, allowing them to evaluate their own material resources and determine where it places them relative to their community. Here, we sought to compare the MacArthur Scale of Subjective Social status to the WAMI, an objective measure of SES that includes data on water and sanitation, asset ownership, education, and income.MethodsLeveraging a study of 595 tuberculosis patients in Lima, Peru, we compared the MacArthur ladder score to the WAMI score using weighted Kappa scores and Spearman’s rank correlation coefficient. We identified outliers that fell outside the 95th percentile and assessed the durability of the inconsistencies between scores by re-testing a subset of participants. We then used Akaike information criterion (AIC) to compare the predictability of logistic regression models evaluating the association between the two SES scoring systems and history of asthma.ResultsThe correlation coefficient between the MacArthur ladder and WAMI scores was 0.37 and the weighted Kappa was 0.26. The correlation coefficients differed by less than 0.04 and the Kappa ranged from 0.26 to 0.34, indicating fair agreement. When we replaced the initial MacArthur ladder scores with retest scores, the number of individuals with disagreements between the two scores decreased from 21 to 10 and the correlation coefficient and weighted Kappa both increased by at least 0.03. Lastly, we found that when we categorized WAMI and MacArthur ladder scores into three groups, both had a linear trend association with history of asthma with effect sizes and AICs that differed by less than 15% and 2 points, respectively.ConclusionOur findings demonstrated fair agreement between the MacArthur ladder and WAMI scores. The agreement between the two SES measurements increased when they were further categorized into 3–5 categories, the form in which SES is often used in epidemiologic studies. The MacArthur score also performed similarly to WAMI in predicting a socio-economically sensitive health outcome. Researchers should consider subjective SES tools as an alternative method for measuring SES, particularly in large health studies where data collection is a burden.