Social Stratification and Inequality

Moderated moderation modelling of subjective social status, pocket money and depressive symptoms of university students in Ghana

Introduction

Although the relationship between subjective social status and depression in university students has been well-established, this association could be seen as a spurious one. Previous studies have shown that key variables like financial resources and age could play key roles in explaining the variances in social status and mental health outcomes. In this research, we assessed the complex interrelationships between subjective social status, financial resources at their disposal and depressive symptoms among university students within their young and middle adulthood stages.

Methods

A cross-sectional survey was conducted in a university in Ghana to sample 1134 university students through accidental sampling. The McArthur Scale and WHO-5 Well-being measure were used for the data collection.

Results

The results revealed that higher levels of subjective social status were associated with lower levels of depression. It was further found that the interaction between students' pocket money and age played unique roles in the relationship between subjective social status and depression.

Conclusion

The study findings call on stakeholders in education to explore funding opportunities and to examine ways of empowering parents (financially) to adequately support the students. Health educationists and promoters, including psychologists, school counsellors and parents could compliment these efforts by helping to train and empower students through self-regulation or management skills to help improve their well-being. Continuous efforts are required to improve the financial status and mental health of students.

Income Is a Stronger Predictor of Subjective Social Class in More Economically Unequal Places

In this research, we examine how the lay conceptualization of subjective social class varies based on economic contexts. We argue that income should be a more central component of subjective social class in areas with higher income inequality. To address the issue of low power in existing research, we combined local-level income inequality indicators with large-scale repeated cross-sectional data, enabling the most reliable test to date on how the relationship between income and subjective social class is moderated by inequality. We used nationally representative datasets from the United States and South Korea (encompassing 25,000+ participants from 1,246 regional-year units). In both cultural contexts, our multilevel models revealed that income is a stronger predictor of subjective social class in regions with higher levels of income inequality. This work advances the theoretical and empirical understanding of how income and income inequality interact to shape the perception of one's position in the social hierarchy.

The dynamic relationship between subjective social status and health: Evidence from a Chinese cohort study

PURPOSE

Using nationally representative longitudinal data from 2010 to 2018 in China, this study systematically investigates the relationship between Subjective Social Status (SSS) and health (physical health and mental health) in the Chinese adult population.

METHODS

By applying between-within model, we disentangle the relationship between health outcomes and: (1) between-individual differences in SSS and (2) within-individual variations of SSS across time. In addition, to explore SSS mobility and trajectory, we further decomposed SSS into lagged SSS and the change between the current and lagged SSS (mobility).

RESULTS

We find that there is significantly positive and unique relationship (independent of Objective Social Status (OSS)) between SSS and physical and mental health. However, for physical health, we observed an Inverse-U effect of average SSS, after some point (SSS = 3.93), higher average SSS is associated with a score decrease. Through heterogeneity analysis, we find that for physical health, within- and between-effects decreases with age and for mental health, the within effect is only significant among the urban population. Individuals with high expected mobility are also found to have significantly better health.

CONCLUSIONS

These findings show that the personal relative deprivation has negative, particularly salient and unique effects on the health of the Chinese population, and it is important to consider the dynamic nature of SSS.

Exploring the experiences of pregnant women in the U.S. during the first year of the Covid-19 pandemic

In this paper, we integrate the stress process model with symbolic interactionism to frame our analysis of interviews with 35 women who were pregnant and/or gave birth during the first year of the Covid-19 pandemic. We detail three stressors, highlight their variation, and discuss how they coped with these stressors. Women reported having to navigate contradictory information about the public health crisis, but Black participants simultaneously endured added strain from a heightened awareness of racialized violence. To cope with an overabundance of precarious and contradictory messages, some women sought out information (i.e., information gatherers), others eschewed information (i.e., information avoiders), and most established protective "bubbles." Next, women experienced disruptions in pregnancy rituals but coped by reframing their expectations. This stressor, however, was less acute for women with a prior birth. Third, women shared feelings of social isolation and reduced social support, which were intensified if pregnancy complications occurred. Women coped by relying on telecommunication and at-home monitoring devices. Our study shows how pregnant women experienced and coped through adversity to mitigate stressors amid pandemonium.

An examination of the medicalization and pharmaceuticalization processes of anxiety and depressive disorders in Belgium between 2004 and 2013: how may both disorders be intertwined?

Background

While medicalization and pharmaceuticalization trends of feelings of anxiety and depression have been described in great detail, an empirical examination of these trends is to date lacking. The current study fills this gap in the literature by mapping the use of psychotropic medicines for feelings of anxiety and depression between 2004 and 2013 in Belgium, as well as by examining whether a social gradient might act as a mediator.

Methods

We analyzed data from three repeated cross-sectional waves (2004, 2008, and 2013) of the Belgian National Health Interview Survey (HIS). Multinomial logistic regression was applied to estimate odds in psychotropic drugs use over the observed period.

Results

Using an ideal-typical distinction between traditional anxiety drugs (psycholeptics) and depression drugs (psychoanaleptics), we found that treatment methods for feelings of anxiety and depression were converging. Persons having feelings of anxiety consumed less psycholeptic drugs, in favor of psychoanaleptic drugs throughout the observed period. Moreover, these results were partially mediated by educational level. Persons with higher education were less likely to consume psychotropic drugs than those with lower education, suggesting a trend of demedicalization for feelings of anxiety and depression.

Limitations

Our study observes a limited period, makes use of an ideal typical distinction between psycholeptic and psychoanaleptic drugs, and measurements may be biased by response-bias due to psychotropic drugs use.

Conclusion

Our study shows that psycholeptics increasingly give way to psychoanaleptics in the treatment of both anxiety and depression, despite several scientists calling their effectiveness for both disorders into question.

Trajectories of health-related quality of life by change pattern of objective and subjective social status

Long-term and cumulative social experiences influence an individual's objective and subjective social status. Social determinants of health are more effectively investigated by longitudinal rather than cross-sectional studies. The primary focus of this study was the prospective effect of socioeconomic transition on health-related quality of life trajectories. The study population were adults over 18 years of age who responded in all nine waves of the Korea Health Panel (2009–2017). Data were analyzed by group-based trajectory modeling to identify health trajectories, and group-based multi-trajectory modeling to investigate combined change patterns of objective and subjective social status (i.e., multi-SES trajectories). To predict the effects of underlying socioeconomic measures on health trajectory group membership, we included these time-stable covariates in trajectory modeling and estimated the risk of belonging to each trajectory based on the measures. The health-related quality of life trajectories showed three patterns during the period 2013 to 2017; 13.7% of individuals had a low and declining health trajectory and the others had a higher stable health trajectory. Four types of multi-SES trajectory were derived during the period 2009 to 2013; the richer had a steeper income slope while there were slight changes in subjective social status among all groups. These combined longitudinal SES patterns in 2009–2013 were strong predictors of subsequent health trajectory group membership in 2013–2017. These findings indicate that rich countries, such as South Korea, may encounter growing income inequality, where individuals become entrenched in income disparity that pins down their perceptions of social position. Over time this rigid social structure will widen the gap in health-related quality of life.

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Changes in health are strongly influenced by changes in the combined patterns of objective and subjective social status.

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Objective and subjective social status interact, forming distinct trajectories in the life-course.

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Benefits from society are concentrated on the privileged, exacerbating income inequality and health disparities over time.

Examining the multilevel associations between psychological wellbeing and social trust: A primary analysis of survey data

The present study examines the associations between multiple measures of social trust and two outcomes of psychological wellbeing (happiness and depression) among South Korean adults (n = 1549) living in residential communities, that is, administrative districts (n = 77) in and around the capital city of Seoul. Based on multilevel modeling, we find that familial trust positively predicts happiness at both individual and contextual levels; and it negatively predicts depression at the individual level only. In comparison, peer trust is negatively related only to depression at the individual level, albeit marginally. Lastly, general trust significantly predicts both outcomes at the community, but not individual, level. These mixed findings suggest that the trust-wellbeing relationship depends critically on issues of definition (how the variables are conceptualized) and measurement (how they are operationalized according to different units of analysis). Our study offers implications for the literature on social determinants of mental health broadly and, more specifically, on the role of social trust.

Subjective social status and health: Multidisciplinary explanations and methodological challenges

Since the early 2000s, evidence has been accumulating that subjective social status – a person’s sense of their own position on the social ladder – affects health above and beyond objective socioeconomic status. To date, however, little is known about how these distinct health effects of subjective social status can be explained. This article narratively reviews different explanatory approaches and key methodological challenges, backed up by empirical findings and supplemented by the authors’ own reflections. Both social–psychological and psychoneurobiological explanations can make a theoretically plausible contribution to explaining the subjective social status–health relationship. Experimental and panel designs appear promising for addressing important methodological challenges in this strand of research.

Physical-psychiatric comorbidity: patterns and explanations for ethnic group differences

OBJECTIVE

This paper examines ethnic differences in the co-occurrence of physical and psychiatric health problems (physical-psychiatric comorbidity) for women and men. The following ethnic groups are included: Non-Latino Whites, African Americans, Caribbean Blacks, Spanish Caribbean Blacks, Mexicans, Cubans, Puerto Ricans, Other Latinos, Chinese, Filipinos, Vietnamese, and Other Asian Americans. In addition, the study assesses the extent to which social factors (socioeconomic status, stress exposure, social support) account for ethnic differences in physical-psychiatric comorbidity (PPC).

DESIGN

This study uses data from the Collaborative Psychiatric Epidemiology Surveys (CPES) (N = 12,787). Weighted prevalence rates of physical-psychiatric comorbidity (PPC) - the co-occurrence of physical and psychiatric health problems - are included to examine ethnic group differences among women and men. Multinomial logistic regression analysis was used to determine group differences in PPC before and after adjusting for social factors.

RESULTS

Puerto Rican men have significantly higher risk of PPC in comparison to Non-Latino White men. Among women, Blacks and Cubans were more likely than Non-Latino Whites to experience PPC as opposed to 'Psychiatric Only' health problems. Social factors account for the Puerto Rican/Non-Latino White difference in comorbid health among men, but have little explanatory power for understanding ethnic differences in comorbidity among women.

CONCLUSION

These findings have implications for medical care and can guide intervention programs in targeting a specific constellation of co-occurring physical and psychiatric health problems for diverse ethnic groups in the United States. As comorbidity rates increase, it is crucial to identify the myriad factors that give rise to ethnic group differences therein.

Age Group Differences in Perceived Age Discrimination: Associations With Self-Perceptions of Aging

Background and Objectives

From midlife onwards, age stereotypes increasingly underlie social judgments and contribute to age-based discrimination. Whereas many studies compare differences between young and older adults in reports of age discrimination or sensitivity to age stereotypes, few consider age group differences among adults over 50. We form subgroups corresponding to social age group membership (early midlife, late midlife, young old, oldest old) and examine differences in reported experiences of everyday age discrimination and associations with self-perceptions of aging.

Research Design and Method

Using cross-sectional and longitudinal data from the Health and Retirement Study (HRS: N = 15,071; M Age = 68, range 50-101), multivariate logistic regression was used to examine experiences of everyday discrimination attributed to age, and associations between age discrimination and self-perceptions of aging, in four age groups: early midlife, late midlife, young old, oldest old.

Results

People in the early midlife group (aged 50-59) reported more experiences of unfair treatment than the older age groups but were less likely to attribute their experiences to age discrimination. After controlling for covariates, individuals in all age groups who perceived their own aging positively were less likely to report experiences of age discrimination. The magnitude of this effect, however, was greatest in the early midlife group.

Discussion and Implications

Findings support proposals that midlife is a pivotal life period when individuals adjust to life events and social role transitions. Future longitudinal studies will provide further insight into whether positive self-perceptions of aging are especially important in this phase of the life course.

The race paradox in subjective wellbeing among older Americans

This study aims to assess racial differences in subjective wellbeing (SWB) and to examine whether the pathways of social support and social engagement to SWB vary by racial groups in the United States of America. Using a local sample (N = 1,035) and a nationally representative sample of the Health and Retirement Study (N = 7,718), we compared life satisfaction and happiness between non-Hispanic Whites and Blacks aged 55 and over. We evaluated the extent to which race, other socio-demographic characteristics, health, social engagement and social support explained the variances in SWB and examined the moderation effects of race on the relationships of SWB with age, social support and social engagement. Multiple regression analyses showed that non-Hispanic Blacks were at least as satisfied as, and even happier than White peers, after equalising social resources and health variables. Social support was significantly related to SWB, and it seemed that positive support was more important to Whites than to Blacks in predicting life satisfaction. In addition, the racial crossover effect existed, that is, the old-old (80+) Blacks were happier than their White peers. Findings indicate a national trend of the race paradox in SWB and underscore the importance of social support in promoting older adults’ wellbeing. Future research is recommended to investigate other potential mechanisms among Black older Americans to explain their relatively better SWB.

Homophobic Violence, Coping Styles, Visibility Management, and Mental Health: A Survey of Flemish Lesbian, Gay, and Bisexual Individuals

The understanding of how lesbians, gays, and bisexuals cope with homophobic violence is limited. Therefore, on the one hand, this study focuses on avoidance, problem-oriented, and emotion-oriented coping as general coping styles. On the other hand, special attention is paid to visibility management as a coping strategy that can be applied in a heteronormative context. Moreover, the moderating role of general coping styles and visibility management in the relationship between homophobic violence and negative mental health outcomes is studied. Data were collected from 1,402 Flemish lesbians, gays, and bisexuals. Stepwise regression analyses shows that coping styles and visibility management have a direct effect on mental health; however, no evidence for a moderating effect is found. Additionally, visibility management and emotion-oriented coping are found to exert a combined effect on mental health.

In control or fatalistically ruled? The sense of mastery among working Canadians

Using data from a 2011 nationally representative sample of Canadian workers (N = 5,576), the present study evaluates the social-structural determinants of the sense of mastery. Three main contributions emerge. First, we document that each of the main components of socioeconomic status--education, income, occupation, and economic hardship--have distinct total, indirect, and net associations with mastery. The well-educated report more mastery because of their higher earnings--but exposure to more role blurring and work-family conflict offset what would otherwise be their even higher levels of mastery. Second, job-related demands and resources have largely independent associations with mastery, but our analyses also reveal some key areas of overlap. Third, role-blurring activities--and their connections with work-to-family conflict and family-to-work conflict--offer unique expansions to the overall narrative of mastery, with unexpected explanatory and suppression effects. We interpret each of these observations in an effort to advance recent theoretical perspectives about mastery.

The H1N1 pandemic: media frames, stigmatization and coping

Background

Throughout history, people have soothed their fear of disease outbreaks by searching for someone to blame. Such was the case with the April 2009 H1N1 flu outbreak. Mexicans and other Latinos living in the US were quickly stigmatized by non-Latinos as carriers of the virus, partly because of news reports on the outbreak’s alleged origin in Mexican pig farms.

Methods

In this exploratory study we examined the psychological processes of cue convergence and associative priming, through which many people likely conflated news of the H1N1 outbreak with pre-existing cognitive scripts that blamed Latino immigrants for a variety of social problems. We also used a transactional model of stress and coping to analyze the transcripts from five focus groups, in order to examine the ways in which a diverse collection of New England residents appraised the threat of H1N1, processed information about stereotypes and stigmas, and devised personal strategies to cope with these stressors.

Results

Twelve themes emerged in the final wave of coding, with most of them appearing at distinctive points in the stress and coping trajectories of focus group participants. Primary and secondary appraisals were mostly stressful or negative, with participants born in the USA reporting more stressful responses than those who were not. Latino participants reported no stressful primary appraisals, but spoke much more often than Whites or Non-Hispanic Blacks about negative secondary appraisals. When interactions between participants dealt with stigmas regarding Latinos and H1N1, Latinos in our focus groups reported using far more negative coping strategies than Whites or Non-Hispanic Blacks. When discussions did not focus on stereotypes or stigmas, Latino participants spoke much more often about positive coping strategies compared to members of these same groups.

Conclusions

Participants in all five focus groups went through a similar process of stress and coping in response to the threat of H1N1, though individual responses varied by race and ethnicity. Stigmatization has often been common during pandemics, and public health and emergency preparedness practitioners can help to mitigate its impacts by developing interventions to address the social stressors that occur during outbreaks in highly-localized geographic regions.

Adolescent mental health, behavior problems, and academic achievement

Prior research on the association of mental health and behavior problems with academic achievement is limited because it does not consider multiple problems simultaneously, take co-occurring problems into account, and control for academic aptitude. We addressed these limitations using data from the National Longitudinal Study of Adolescent Health (N = 6,315). We estimated the associations of depression, attention problems, delinquency, and substance use with two indicators of academic achievement (high school GPA and highest degree received) with controls for academic aptitude. Attention problems, delinquency, and substance use were significantly associated with diminished achievement, but depression was not. Combinations of problems involving substance use were especially consequential. Our results demonstrate that the social consequences of mental health problems are not the inevitable result of diminished functional ability but, rather, reflect negative social responses. These results also encourage a broader perspective on mental health by demonstrating that behavior problems heighten the negative consequences of more traditional forms of distress.