Psychological resources as mediators of the association between social class and health: comparative findings from Japan and the USA

The social class of orthopedic rehabilitation patients: Are there differences in subjective health, return to work motivation, and participation in aftercare interventions?

This longitudinal quasi-experimental study examines the relationship between social class, subjective health, motivation to return to work (RTW) following medical rehabilitation, and participation in aftercare interventions, utilizing the Social Cognitive Theory of Social Class. To do so, a prospective multicentric study was conducted. The analysis was based on data from N = 1044 orthopedic rehabilitation patients in three clinics in Germany. Latent growth curve models, fixed-effect linear regression models, and multilevel binomial logistic regression were employed for data analysis. As hypothesized, the findings demonstrate that lower social class is associated with poorer subjective health, while higher social class is linked to increased solipsistic motives, characterized by pursuing personal goals in the context of RTW. Conversely, individuals from lower social classes exhibit contextualist motives, which indicate a focus on social and environmental threats influencing their motivation to RTW. Surprisingly, social class does not significantly impact participation in aftercare interventions, probably due to low variance and potentially the successful inclusion within the German healthcare system. These findings emphasize the importance of considering diverse motivation profiles derived from the Social Cognitive Theory of Social Class. The study contributes to our understanding of the social determinants of health and has implications for reducing health disparities by highlighting the motivational aspects, including solipsistic and contextualist motives, associated with social class.

The role of social cognitions in the social gradient in adolescent mental health: A longitudinal mediation model

The social gradient in adolescent mental health is well established: adolescents' socioeconomic status is negatively associated with their mental health. However, despite changes in social cognition during adolescence, little is known about whether social cognitions mediate this gradient. Therefore, this study tested this proposed mediational path using three data waves, each 6 months apart, from a socioeconomically diverse sample of 1,429 adolescents (Mage = 17.9) in the Netherlands. Longitudinal modeling examined whether three social cognitions (self-esteem, sense of control, and optimism) mediated associations between perceived family wealth and four indicators of adolescent mental health problems (emotional symptoms, conduct problems, hyperactivity, and peer problems). There was evidence of a social gradient: adolescents with lower perceived family wealth reported more concurrent emotional symptoms and peer problems and an increase in peer problems 6 months later. Results also showed evidence of mediation through social cognitions, specifically sense of control: adolescents with lower perceived family wealth reported a decrease in sense of control (though not self-esteem nor optimism) 6 months later, and lower sense of control predicted increases in emotional symptoms and hyperactivity 6 months later. We found concurrent positive associations between perceived family wealth and all three social cognitions, and concurrent negative associations between social cognitions and mental health problems. The findings indicate that social cognitions, especially sense of control, may be an overlooked mediator of the social gradient in adolescent mental health.

Effects of Subjective Social Status and Self-Esteem in the Association Between Childhood Abuse and Adulthood Anxiety

Background

Subjective social status influences anxiety, but at present, the mechanism is not fully understood. It has been reported that negative childhood experiences, such as abuse, can influence depressive symptoms through subjective social status and personality traits, such as self-esteem. A similar mechanism is presumed to underlie anxiety symptoms in adulthood. Therefore, we hypothesized that subjective social status and self-esteem are intermediate factors in the indirect effects of childhood abuse on state anxiety in adulthood, and analyzed the indirect effects via these factors using a path analysis.

Subjects and Methods

Child Abuse and Trauma Scale, Subjective Social Status, Rosenberg Self-Esteem Scale, and State-Trait Anxiety Inventory Form Y questionnaires were administered in a self-report format to 404 adult volunteers from January 2014 to August 2014. In addition, a path analysis was conducted to determine whether subjective social status and self-esteem are associated with the indirect effects of childhood abuse on anxiety symptoms in adulthood.

Results

Childhood abuse did not directly affect state anxiety in adulthood, but affected state anxiety via subjective social status and self-esteem. Subjective social status affected state anxiety via self-esteem. This model explained 25.2% of the variation in state anxiety in adult volunteers.

Conclusion

The present study demonstrated that childhood abuse affects anxiety in adulthood through subjective social status and self-esteem. Therefore, interventions that enhance subjective social status and self-esteem for adults who experienced childhood abuse may help reduce their anxiety.

A pilot cross-sectional investigation of chronic shame as a mediator of the relationship between subjective social status and self-rated health among middle-aged adults

Subjective social status (SSS) is an important independent predictor of health outcomes, however, the pathways through which it affects health are poorly understood. Chronic shame has previously been suggested as a potential mechanism but this has never been investigated and the relationship between chronic shame and health is under-researched. The purpose of this pilot study was to explore whether chronic shame explains a significant portion of the association between SSS and self rated health (SRH). Two-hundred American adults aged 30-55 years were recruited via a crowd-sourcing platform and were asked to provide information on their SSS, level of chronic shame, and SRH. Chronic shame significantly mediated the relationship between SSS and SRH. This pilot study provides initial evidence that shame explains a significant portion of the relationship between subjective social status and self-rated health. These findings support the initiation of larger, longitudinal investigations into chronic shame as a mediator of the subjective social status and self-rated health relationship.

Headache impact and socioeconomic status: findings from a study of the German Migraine and Headache Society (DMKG)

BACKGOUND

Headache disorders are not only among the most prevalent, they are also among the most disabling disorders worldwide. This paper investigates the association between headache impact on daily life and the socioeconomic status (SES) of headache sufferers.

METHODS

Data stem from a random general population sample in Germany. Respondents who reported having headache for at least a year and were aged ≥ 18 years were included in the study. A standardized questionnaire addressing headache and headache treatment was filled in during the face-to-face survey. The impact of headache on daily life was measured using the German version of the Headache Impact Test (HIT-6).

RESULTS

Higher headache impact was found in low and medium SES compared to high SES. After adjustment for sociodemographics, headache-related factors (analgesic use, headache duration, headache frequency, migraine diagnosis), depressive symptoms, physical inactivity and obesity, an increased odds ratio of having higher headache impact in low SES compared to high SES was found: OR = 1.83, 95% CI [1.43, 2.23], p = .014. When the interactions "SES*obesity", "SES*depressive symptoms", and "SES*physical inactivity" were added, the results showed a significant interaction effect of "SES*obesity". Obese persons with low SES were 3.64 times more likely to have higher headache impact than non-obese persons with low SES. No significant differences between obese and non-obese persons were found in the medium and high SES groups.

CONCLUSIONS

SES is an important factor that should not be neglected in headache awareness campaigns and headache treatment. Longitudinal studies are needed in the future to investigate whether lifestyle interventions, such as weight reduction, can help to reduce headache impact in people in lower SES.

The relationship between duration of subjective poverty and health among Chinese adults: Evidence from the China Family Panel Study

Introduction

The disadvantaged socioeconomic status could have accumulated negative effects on individual. In the Chinese context, studying subjective and relative poverty is more important under the implementation of the Targeted Poverty Alleviation campaign. This study aims to provide evidence of the relationship between the duration of subjective poverty and both physical and mental health among Chinese adults, using nationally longitudinal data from 2010 to 2018.

Materials and methods

Data were extracted from a nationally representative survey database-the China Family Panel Study (CFPS). The total sample size contains 12,003 adults, with 3,532 in the urban area and 8,471 in the rural area. Self-rated health and depressive symptoms were set as indicators of physical health and mental health, respectively. The duration of subjective poverty was measured by self-rated income level in the local area from 2010 to 2016. A series of ordinary least square regression was adopted to measure the relationship between duration of subjective poverty and health.

Results

For the urban residents, the average duration of subjective poverty is 1.99 time points, while 1.98 time points for the rural residents. Net of objective poverty, duration of subjective poverty has a significantly negative association with individual's self-rated health in the rural sample (Coef. = -0.10, p < 0.001). Compared with those who have not experienced subjective poverty, the self-rated health score of people who experienced four time points is likely to decrease by 0.54 in the rural area and 0.30 in the urban area. In terms of mental health, 1 unit increase in the duration of subjective poverty is related to 0.15 unit increase in Center for Epidemiologic Studies Depression Scale-8 (CES-D8) scores in the urban sample and 0.46 in the rural sample. Compared with those who have not experienced subjective poverty, the CES-D8 scores of people who experienced four time points are likely to increase by 1.47 in the rural area and 0.95 in the urban area.

Conclusion

A longer duration of subjective poverty has a cumulatively negative effect on Chinese residents' physical and mental health, especially in rural area. Our study advocates researchers and policymakers pay more attention to the cumulative effect of subjective poverty on health.

Associations of family subjective socioeconomic status with hedonic and eudaimonic well-being in emerging adulthood: A daily diary study

Empirical evidence based on retrospective measures has shown that family subjective socioeconomic status (FSSS) was connected to well-being, but few studies have examined this relationship using a daily diary design. Here, we examined the link between FSSS and well-being as well as the mediating roles of social support and self-esteem in a total of 220 emerging adults using a 14-day daily diary design. The multilevel regression analysis found that FSSS positively predicted two types of well-being, including hedonic well-being (HWB) and eudaimonic well-being (EWB). Moreover, the multilevel 2-2-1 mediation analysis indicated that social support and self-esteem performed as independent mediators of the associations between FSSS and two types of well-being. The mediating effect of self-esteem also had no significant difference from that of social support. Furthermore, when age, gender, and family objective socioeconomic status were controlled, these findings remained significant. The implications and limitations of the findings are also discussed.

Are stress-related pathways of social status differentiation more important determinants of health inequities in countries with higher levels of income inequality?

We explored socioeconomic gradients in self-rated overall health (SROH) using indicators of materialist (educational attainment and perceived income adequacy) and psychosocial perspectives (subjective social status (SSS)) among adults living in countries with varying levels of income inequality, and the importance of psychosocial stress in mediating these associations. If psychosocial processes at the individual and societal levels correspond, associations between SSS and SROH should be higher among adults in countries with higher income inequality, and psychosocial stress should be a more important mediator of these associations. We used multigroup structural equation models to analyse cross-sectional data from the International Food Policy Study of adults (n = 22,824) in Australia, Canada, Mexico, the UK and the United States. Associations between SSS and SROH were not higher in more unequal countries, nor was psychosocial stress a more important mediator of these associations. Inequities in SROH in more unequal countries may not predominantly reflect stress-related pathways of social status differentiation.

Childhood maltreatment, subjective social status, and health disparities in bereavement

BACKGROUND

Spousal bereavement can lead to adverse health outcomes; however, not all widow(er)s experience the same degree of health problems. Thus, it is important to understand the contribution of disparities (e.g., childhood maltreatment and subjective social status) that may underlie adverse health outcomes that arise following bereavement.

METHODS

We collected data from 130 spousally bereaved individuals at 3-time points (3 months post-loss, 4 months post-loss, and 6 months post-loss). Using mixed models, we assessed the interaction of childhood maltreatment, subjective social status, and time to predict changes in proinflammatory cytokine production, depressive symptoms, grief symptoms.

RESULTS

We found a significant interaction between childhood maltreatment, subjective social status, and time predicting proinflammatory cytokine production (beta > -0.01, p = 0.048), depressive symptoms (beta = 0.008, p = .010), and grief symptoms (beta = 0.001 p = .001).

CONCLUSION

This study highlights the role of disparities related to childhood maltreatment and subjective social status on adverse health outcomes following spousal bereavement.

Stress-Related Poor Diet Quality Does Not Explain Socioeconomic Inequities in Health: A Structural Equation Mediation Analysis of Gender-Specific Pathways

BACKGROUND

Psychosocial stress and diet quality individually mediate associations between socioeconomic position (SEP) and health; however, it is not known whether they jointly mediate these associations. This is an important question because stress-related unhealthy eating is often invoked as an explanation for diet-related health inequities, particularly among women, seemingly with no empirical justification.

OBJECTIVE

This study examined whether psychosocial stress and diet quality jointly mediated associations between SEP and self-rated health in women and men.

DESIGN

Multiple mediating pathways were modeled using data from the cross-sectional International Food Policy Study.

PARTICIPANTS AND SETTING

Data were collected from 5,645 adults (aged 18 years or older) in Canada during 2018 and 2019.

MAIN OUTCOME MEASURES

Participants reported SEP using indicators of materialist (educational attainment and perceived income adequacy) and psychosocial pathways (subjective social status), along with psychosocial stress, dietary intake (to assess overall diet quality via Healthy Eating Index-2015 scores), and self-rated health.

STATISTICAL ANALYSES PERFORMED

Structural equation modeling modeled pathways linking SEP (ie, educational attainment, perceived income adequacy, and subjective social status) with self-rated health mediated by psychosocial stress and diet quality, stratified by gender.

RESULTS

There was no evidence that psychosocial stress and diet quality jointly mediated associations between SEP and self-rated health in women or men. Diet quality mediated associations between educational attainment and self-rated health in women and men, with some evidence that it mediated associations between subjective social status and self-rated health in men (P = 0.051). Psychosocial stress mediated associations between perceived income adequacy and self-rated health in women and men, and between subjective social status and self-rated health in women.

CONCLUSIONS

Although often invoked as an explanation for diet-related health inequities, stress-related poor diet quality did not mediate associations between SEP and self-rated health in women or men. Psychosocial stress and diet quality individually mediated some of these associations, with some differences by gender.

Culture and Health: Recent Developments and Future Directions 1

Evidence of cultural differences in relationships and emotions has accumulated over the past few decades. As findings on cultural differences in psychological processes have accumulated, there has been growing interest in investigating whether they have implications for other phenomena such as health. Using scientific advances from the MIDUS and MIDJA studies, both publicly available, we examine links between culture and health. We first briefly review the accumulated evidence on cultural influences on health correlates of psychosocial factors. We then feature two recent developments - a more micro-level perspective on biological factors that may be involved in the culture and health linkage, and a more macro-level view of socioeconomic inequality, which also matters for health. Both perspectives inform the pathways through which health effects occur. Finally, we conclude our review by highlighting the changing historical contexts surrounding these cross-cultural investigations. Specifically, we draw attention to widening of economic inequality across cultures and the world-wide COVID-19 pandemic. These happenings bring notable implications for future research on health across cultural contexts.

Longitudinal Associations Between Perceived Control and Health for American and Japanese Aging Adults

BACKGROUND AND OBJECTIVES

Research suggests longitudinal and reciprocal relationships between perceived control over life circumstances and health for Western populations; yet, such associations have not been fully understood for non-Western populations. The present study addresses cultural differences in these associations for American and Japanese aging adults.

RESEARCH DESIGN AND METHODS

For respondents aged 40 and older at 2 waves (Time 1 [T1] and Time 2 [T2]) of Midlife in the United States (N = 4,455) and Midlife in Japan (N = 827), cross-lagged path models were analyzed for T1 perceived control predicting change in each health measure (i.e., self-rated health, number of chronic health conditions, and functional limitations) from T1 to T2; and the matched T1 health measure predicting change in perceived control from T1 and T2. In these analyses, the effects of T1 age, T1 perceived control, and each T1 health measure were compared cross-nationally.

RESULTS

A cross-national difference emerged in that T1 perceived control predicted change in chronic health conditions only for Americans. Similar tendencies were found between the 2 nationalities for T1 perceived control predicting changes in self-rated health and functional limitations. Reciprocal relationships between perceived control and health measures were found for Americans, but neither age nor any of the T1 health measures predicted change in perceived control for the Japanese respondents.

DISCUSSION AND IMPLICATIONS

The findings suggest cultural differences and similarities between the 2 nationalities, which have implications for potential health benefits of enhancing perceived control among American and Japanese aging adults. Building on these findings, the present study also indicates future directions of research.

Dispositional Optimism and Disaster Resilience: A natural experiment from the 2011 Great East Japan Earthquake and Tsunami

OBJECTIVE

Dispositional optimism - the general belief that good things will happen - is considered a key asset for the preservation of mental health after a traumatic life event. However, it has been hypothesized that in extreme situations such as major disasters where positive expectations cannot overcome the grim reality on the ground, being optimistic might be a disadvantage. To test this mismatch hypothesis, this study explores whether higher pre-disaster dispositional optimism is associated with higher posttraumatic stress (PTS) and depressive symptoms among individuals who experienced the 2011 Great East Japan Earthquake and Tsunami.

METHODS

Information on optimism was collected from community-dwelling residents aged ≥65 years seven months before the 2011 Earthquake/Tsunami in Iwanuma, a Japanese city located 80-km from the epicenter. Data on disaster-related personal experiences (e.g., loss of relatives or friends/housing damage), as well as depressive and PTS symptoms, were collected during a follow-up survey in 2013, 2.5 years after the earthquake and tsunami. Multiple logistic regression models were utilized to evaluate the associations between disaster experiences, optimism, and depressive/PTS symptoms among 962 participants.

RESULTS

Higher pre-disaster dispositional optimism was associated with lower odds of developing depressive symptoms (OR = 0.78, 95% CI: 0.65 to 0.95) and PTS symptoms (OR = 0.83, 95% CI: 0.69 to 0.99) after the earthquake. Contrary to the mismatch hypothesis, high dispositional optimism buffered the adverse impact of housing damage on depressive symptoms (interaction term coefficient = -0.63, p = 0.0431), but not on PTS symptoms.

CONCLUSIONS

In contrast to the mismatch hypothesis, the results suggest that dispositional optimism is a resilience resource among survivors of a disaster.

Japanese version of the 42-item psychological well-being scale (PWBS-42): a validation study

BACKGROUND

The aim of this study was to examine the internal consistency, structural validity, and convergent/known-group validity of the Japanese version of the 42-item Psychological Well-Being Scale (PWBS-42).

METHODS

The PWBS-42 includes six 7-item subscales designed to measure the following dimensions of eudaimonic psychological well-being: 1) autonomy, 2) environmental mastery, 3) personal growth, 4) positive relations with others, 5) purpose in life, and 6) self-acceptance. A questionnaire was administered to 2102 community residents in Tokyo aged 30 or over as a part of the Midlife in Japan (MIDJA) survey, in 2008. The internal consistency reliability was tested using Cronbach's α. Structural validity was examined using exploratory factor analysis (EFA). Convergent validity was evaluated by calculating correlations of the Japanese PWBS-42 subscales with life satisfaction, negative affect, negative adjectives, positive affect, positive adjectives, self-esteem, and perceived stress scales.

RESULTS

Data from 1027 respondents (505 males and 522 females) were analyzed (valid response rate = 56.2%). Cronbach's α values ranged from 0.70 to 0.78 for five of the subscales, while that for purpose in life was lower (0.57). EFA yielded a five-factor structure: The first two factors consisted of negative and positive items mostly from the environmental mastery, purpose in life, and self-acceptance subscales. The third, fourth, and fifth factors consisted mostly of items from the positive relations with others, autonomy, and personal growth subscales, respectively. As hypothesized, the scores for life satisfaction, negative and positive affect/adjectives, self-esteem and perceived stress were significantly correlated with all subscales of the Japanese PWBS-42.

CONCLUSION

The subscales of the Japanese version of the PWBS-42 showed accep. levels of reliability and support for convergent validity in the Japanese population. The factor structure was slightly different from the theoretical 6-factor model: items of three subscales (environmental mastery, purpose in life, and self-acceptance) loaded together on two factors. This finding may be interpreted in light of the interdependent self construal found in Japan in which these three components could be closely linked.

Psychosocial and neighborhood correlates of health-related quality of life: A multi-level study among Hispanic adults

OBJECTIVE

Improvement in health-related quality of life (HRQoL) is a public health goal of Healthy People 2020. Hispanics living in the United States are at risk for poor HRQoL, but the causes and correlates of this risk are not well understood. Thus, the present study examined individual-level psychosocial and neighborhood-level built environment correlates of physical and mental HRQoL among Hispanic adults.

METHOD

A community sample of Hispanic adults (N = 383) completed self-report health-related questionnaires, and census tract was used to collect data on neighborhood-level built environment variables. Multilevel modeling was used to examine individual-level psychosocial (language preference, religiosity, subjective social status, discrimination, and number of years lived in the United States) and neighborhood-level built-environment (the retail food environment, proximity to alcohol retailers, and tobacco retailer density) correlates of physical and mental HRQoL.

RESULTS

Higher subjective social status was significantly associated with better HRQoL, and more experiences with discrimination were significantly associated with lower HRQoL. For physical HRQoL, these relationships were stronger in neighborhoods with a higher density of tobacco retail outlets.

CONCLUSIONS

Findings from this study suggest that subjective social status and discrimination play important roles in HRQoL among Hispanics, in particular in neighborhoods with a higher density of tobacco retail outlets. This study highlights the importance of considering neighborhood context, and in particular neighborhood disadvantage, when examining the relationship between social status, discrimination and HRQoL among Hispanics. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Subjective social status and trajectories of self-rated health status: a comparative analysis of Japan and the United States

Background

Japanese society is more egalitarian than the United States as is reflected by the lower degree of prevalence of social inequalities in health. We examined whether subjective socioeconomic status is associated with different trajectories of self-rated health (SRH), and whether this relationship differs between the United States and Japan.

Methods

We analyzed the responses of 3968 Americans from the survey Midlife in the United States, 2004-06, and the responses of 989 Japanese from the survey Midlife in Japan, 2008. We conducted a multilevel analysis with three self-ratings of health (10 years ago, current and 10 years in the future) nested within individuals and nested within 10 levels of subjective social status. Age, sex, educational level and subjective financial situation were adjusted.

Results

After making statistical adjustments for confounding variables, respondents in Japan continued to report lower average levels of health. However, the rate of expected decline in SRH over the next decade was strongly socially patterned in the United States, whereas it was not in Japan.

Conclusion

The Japanese showed no disparity in the anticipated trajectory of SRH over time, whereas the Americans showed a strong social class gradient in future trajectories of SRH.

Scientific imperatives vis-à-vis growing inequality in America

A landmark article published in the American Psychologist (Adler et al., 1994) encouraged psychologists to engage in research on socioeconomic inequality and health. Numerous contributions followed to fill in psychosocial and behavioral pathways. Specifically, we review advances on health inequalities research from a large public-use study (Midlife in the United States [MIDUS]). The Great Recession of 2007 to 2009 and its lingering effects are then reviewed to underscore widening inequality in access to education, employment, and income. Two MIDUS national samples of same-aged adults recruited 2 decades apart are then compared to assess historical changes in socioeconomic, physical health, and well-being profiles from the 1990s to postrecession. Despite historical gains in educational attainment over time, we show that indicators of socioeconomic status, health, and well-being are more compromised in the postrecession sample relative to the 1990s sample. Building on these preliminary findings, we elaborate opportunities for further inquiry by the scientific community to examine whether widening socioeconomic inequalities exacerbated by the Great Recession translate to widening health inequalities. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Subjective social status via mediation of childhood parenting is associated with adulthood depression in non-clinical adult volunteers

Subjective social status (SSS) is associated with major depression, but its association with depressive symptoms remains unknown. In this study, we hypothesized that SSS mediates the effects of the quality of parenting (care and overprotection) on self-esteem and depressive symptoms in adulthood in non-clinical self-selected adult volunteers, and this hypothesis was verified by covariance structure analysis. The following questionnaire surveys were conducted on 404 Japanese non-clinical adult volunteers: Patient Health Questionnaire-9 (PHQ-9), SSS, Parental Bonding Instrument (PBI), and Rosenberg Self-Esteem Scale (RSES). We conducted covariance structure analysis to elucidate the mediating effects of SSS on the effects of PBI on RSES and PHQ-9. In our models, self-esteem, but not the quality of parenting or SSS, directly deteriorated depressive symptoms. Poor quality of parenting in childhood indirectly exacerbated depressive symptoms through the mediating effects of SSS and self-esteem. This study showed that SSS is a mediator in the effects of the quality of parenting in childhood on adulthood depressive symptoms and self-esteem, and that self-esteem further mediates the effects of SSS. Our results may hence contribute to the elucidation of the association between SSS and depression.

Complex effects of childhood abuse, affective temperament, and subjective social status on depressive symptoms of adult volunteers from the community

BACKGROUND

How subjective social status is associated with childhood abuse and affective temperament in the mechanism of depressive symptom exacerbation remains unknown. In this study, we investigated how the complex effects of subjective social status, childhood abuse, and affective temperament influence depressive symptoms in adulthood.

METHODS

Self-report questionnaires were distributed to 853 adult volunteers between January and August 2014. Of them, 404 people gave full consent and returned complete anonymous responses. The following five questionnaires were analyzed: demographic information, Patient Health Questionnaire-9, subjective social status, Child Abuse and Trauma Scale, and Temperament Evaluation of Memphis, Pisa, Paris and San Diego autoquestionnaire. The associations between the scores were analyzed by structural equation modeling. This study was conducted with approval from the ethics committees of Tokyo Medical University and Hokkaido University Hospital.

RESULTS

Covariance structure analysis demonstrated that childhood abuse and subjective social status did not have a direct effect on adulthood depressive symptoms. Childhood abuse had direct effects on subjective social status and affective temperament and childhood abuse indirectly affected adulthood depressive symptoms through subjective social status and affective temperament. Subjective social status also affected depressive symptoms through an effect on affective temperament. This model explained 43% of the variability in depressive symptoms and the fitness of this model was good.

CONCLUSION

Regarding childhood abuse and adulthood depressive symptoms, subjective social status as well as affective temperament may be mediators. The results of this study are expected to contribute to the elucidation of the mechanism of depression.

Culture and social hierarchy: Self- and other-oriented correlates of socioeconomic status across cultures

Current theorizing on socioeconomic status (SES) focuses on the availability of resources and the freedom they afford as a key determinant of the association between high SES and stronger orientation toward the self and, by implication, weaker orientation toward others. However, this work relies nearly exclusively on data from Western countries where self-orientation is strongly sanctioned. In the present work, we predicted and found that especially in East Asian countries, where other-orientation is strongly sanctioned, high SES is associated with stronger other-orientation as well as with self-orientation. We first examined both psychological attributes (Study 1, N = 2,832) and socialization values (Study 2a, N = 4,675) in Japan and the United States. In line with the existent evidence, SES was associated with greater self-oriented psychological attributes and socialization values in both the U.S. and Japan. Importantly, however, higher SES was associated with greater other orientation in Japan, whereas this association was weaker or even reversed in the United States. Study 2b (N = 85,296) indicated that the positive association between SES and self-orientation is found, overall, across 60 nations. Further, Study 2b showed that the positive association between SES and other-orientation in Japan can be generalized to other Confucian cultures, whereas the negative association between SES and other-orientation in the U.S. can be generalized to other Frontier cultures. Implications of the current findings for modernization and globalization are discussed. (PsycINFO Database Record

Neuroticism Predicts Subsequent Risk of Major Depression for Whites but Not Blacks

Cultural and ethnic differences in psychosocial and medical correlates of negative affect are well documented. This study aimed to compare blacks and whites for the predictive role of baseline neuroticism (N) on subsequent risk of major depressive episodes (MDD) 25 years later. Data came from the Americans’ Changing Lives (ACL) Study, 1986–2011. We used data on 1219 individuals (847 whites and 372 blacks) who had data on baseline N in 1986 and future MDD in 2011. The main predictor of interest was baseline N, measured using three items in 1986. The main outcome was 12 months MDD measured using the Composite International Diagnostic Interview (CIDI) at 2011. Covariates included baseline demographics (age and gender), socioeconomics (education and income), depressive symptoms [Center for Epidemiologic Studies Depression Scale (CES-D)], stress, health behaviors (smoking and driking), and physical health [chronic medical conditions, obesity, and self-rated health (SRH)] measured in 1986. Logistic regressions were used to test the predictive role of baseline N on subsequent risk of MDD 25 years later, net of covariates. The models were estimated in the pooled sample, as well as blacks and whites. In the pooled sample, baseline N predicted subsequent risk of MDD 25 years later (OR = 2.23, 95%CI = 1.14–4.34), net of covariates. We also found a marginally significant interaction between race and baseline N on subsequent risk of MDD (OR = 0.37, 95% CI = 0.12–1.12), suggesting a stronger effect for whites compared to blacks. In race-specific models, among whites (OR = 2.55; 95% CI = 1.22–5.32) but not blacks (OR = 0.90; 95% CI = 0.24–3.39), baseline N predicted subsequent risk of MDD. Black-white differences in socioeconomics and physical health could not explain the racial differences in the link between N and MDD. Blacks and whites differ in the salience of baseline N as a psychological determinant of MDD risk over a long period of time. This finding supports the cultural moderation hypothesis and is in line with other previously reported black–white differences in social, psychological, and medical correlates of negative affect and depression.

Culture and social class

A large body of research in Western cultures has demonstrated the psychological and health effects of social class. This review outlines a cultural psychological approach to social stratification by comparing psychological and health manifestations of social class across Western and East Asian cultures. These comparisons suggest that cultural meaning systems shape how people make meaning and respond to material/structural conditions associated with social class, thereby leading to culturally divergent manifestations of social class. Specifically, unlike their counterparts in Western cultures, individuals of high social class in East Asian cultures tend to show high conformity and other-orientated psychological attributes. In addition, cultures differ in how social class impacts health (i.e. on which bases, through which pathways, and to what extent).

Effect of socioeconomic conditions on health care utilization in marital violence: a cross-sectional investigation from the Japanese Study on Stratification, Health, Income, and Neighborhood

Background

The health-care-seeking process while experiencing marital violence can be significantly influenced by one’s socioeconomic status, which limits the availability of resources and opportunities for accessing those resources. This study exploratorily examined the effects of socioeconomic factors on the association between marital violence and health care utilization in Japan.

Methods

Cross-sectional data on 2,984 male and female community residents aged 25 to 50 years was obtained from the first wave of Japanese Study of Stratification, Health, Income, and Neighborhood (J-SHINE) conducted between 2010 and 2011. Multiple logistic regression analysis was conducted to examine the association between marital violence and health care utilization. Interaction terms were used to examine the moderating effect of educational attainment, household income, and employment status on the association. Mediation analysis was conducted to estimate the magnitude of mediating effects of mastery, social support, and health literacy in relation to the moderating effect of socioeconomic factors.

Results

Health care utilization in Japan was more prevalent among those who experienced marital violence (69.4 vs. 65.1%). The association between marital violence and health care utilization differed by employment status at a 0.10 level, while educational attainment and household income did not have substantial influence on health care utilization in the presence of marital violence. None of the psychosocial resources (mastery, health literacy, instrumental support, and informational support) explained the differential association by employment status.

Conclusions

This study highlights the increased health care needs of those experiencing marital violence in Japan. The health care needs of the unemployed are potentially unmet in the presence of marital violence. Removing barriers to health care experienced by the unemployed may be an effective strategy for connecting survivors to needed supports and care.

Childhood Socioeconomic Status and Onset of Depression among Japanese Older Adults: The JAGES Prospective Cohort Study

OBJECTIVE

Previous investigations on the impact of childhood socioeconomic status (SES) on depression have focused on middle-aged adults in Western countries. It is unknown whether childhood SES has a long-latency effect on the onset of depression among older adults.

DESIGN

Prospective cohort study.

SETTING

Data were from the Japan Gerontological Evaluation Study.

PARTICIPANTS

We analyzed 10,458 individuals aged 65 years and older without depression (Geriatric Depression Scale <5) at baseline in 2010.

MEASUREMENTS

Participants rated their childhood SES at the age of 15 years according to standards at that time. We used binomial regression analyses with log link and with adjustment for known and potential risk factors to evaluate the risk of depression onset by 2013.

RESULTS

Overall, 13.9% of participants newly reported depression in 2013. After adjusting for age and sex, low childhood SES was positively associated with depression onset (adjusted risk ratio [ARR]: 1.44, 95% confidence interval [CI]: 1.23-1.69). The association decreased after adjustment for education (ARR: 1.33; 95% CI: 1.13-1.57). Even after adjustments for adult SES, current disease status, health behaviors, and social relationships, the association remained significant (ARR: 1.27; 95% CI: 1.08-1.50). The link was stronger among the younger old (65-74 years) than the oldest old (≥75 years).

CONCLUSIONS

Low childhood SES, perhaps due to poverty in post-World War II, has a long-latency effect on the onset of depression among older Japanese adults. The impact of childhood SES on depression was weaker among the oldest old, suggesting survival effects for healthy older Japanese people.

Childhood socioeconomic disadvantage is associated with lower mortality in older Japanese men: the JAGES cohort study

BACKGROUND

Childhood socioeconomic disadvantage has been previously linked to increased mortality risk in adulthood. However, most previous studies have focused on middle-aged adults in Western contexts. Here, we sought to examine the association between childhood socioeconomic status (SES) and mortality among healthy older Japanese adults.

METHODS

We conducted a 3-year follow-up of participants in the Japan Gerontological Evaluation Study (JAGES), a population-based cohort of 65- to 103-year-old Japanese adults. Childhood SES was assessed by survey at baseline. Mortality from 2010 to 2013 was analysed for 15 449 respondents (7143 men and 8306 women). Cox regression models were used to estimate hazard ratios (HR) for risk of death.

RESULTS

A total of 754 deaths occurred during the 3-year follow-up. Lower childhood SES was significantly associated with lower mortality in men, but not in women. Compared with men growing up in more advantaged childhood socioeconomic circumstances, the age-adjusted HR for men from low childhood SES backgrounds was 0.75 [95% confidence interval (CI): 0.56-1.00]. The association remained significant after adjustment for height, education, adult SES, municipalities of residence, health behaviours, disease status and current social relationships (HR = 0.64; 95% CI 0.47-0.87). This association was stronger among men aged 75 years or older, HR = 0.67 (95% CI: 0.47-0.95), compared with men aged 65-74 years, HR = 0.90 (95% CI: 0.54-1.51).

CONCLUSIONS

Childhood socioeconomic disadvantage is associated with lower mortality among men aged 75 years or older, which may be due to selective survival, or alternatively to childhood physical training or postwar calorie restriction in this generation of Japanese males.

How do we assign ourselves social status? A cross-cultural test of the cognitive averaging principle

Subjective social status (SSS), or one's perceived social standing, is linked robustly to mental and physical health and is thought to be determined in part by a cognitive average of one's past, present and expected socioeconomic status. However, this averaging principle awaits a formal test. Further, cultures differ with regard to how they perceive and discount time. In this study, I draw upon cross-sectional data from the United States and Japan (2005 MIDUS non-Hispanic whites and 2008 MIDJA), which measured subjective status in terms of one's perceived standing within a personally defined community. I compare equal and unequal cognitive averaging models for their goodness of fit relative to a traditional present-based model. Socioeconomic status is assessed broadly, in terms of past, present and expected overall work and financial situations. In the United States, averaging models do not fit the data consistently better than a present-based model of SSS. However, in Japan, averaging models do fit SSS consistently better. These fit conclusions are robust to controlling for negative affect.

Culture, inequality, and health: evidence from the MIDUS and MIDJA comparison

This article seeks to forge scientific connections between three overarching themes (culture, inequality, health). Although the influence of cultural context on human experience has gained notable research prominence, it has rarely embraced another large arena of science focused on the influence social hierarchies have on how well and how long people live. That literature is increasingly focused psychosocial factors, working interactively with biological and brain-based mechanisms, to account for why those with low socioeconomic standing have poorer health. Our central question is whether and how these processes might vary by cultural context. We draw on emerging findings from two parallel studies, Midlife in the U.S. and Midlife in Japan, to illustrate the cultural specificity evident in how psychosocial and neurobiological factors are linked with each other as well as how position in social hierarchies matters for psychological experience and biology. We conclude with suggestions for future multidisciplinary research seeking to understand how social hierarchies matter for people's health, albeit in ways that may possibly differ across cultural contexts.

Subjective social status and health

PURPOSE OF REVIEW

Subjective social status (SSS) predicts health outcomes above and beyond traditional objective measures of social status, such as education, income and occupation. This review summarizes and integrates recent findings on SSS and health.

RECENT FINDINGS

Current studies corroborate associations between low SSS and poor health indicators by extending previous findings to further populations and biological risk factors, providing meta-analytic evidence for adolescents and by demonstrating that negative affect may not confound associations between SSS and self-rated health. Recent findings also highlight the relevance of SSS changes (e.g. SSS loss in immigrants) and the need to consider cultural/ethnical differences in psychological mediators and associations between SSS and health.

SUMMARY

SSS is a comprehensive measure of one's social position that is related to several poor health outcomes and risk factors for disease. Future investigation, particularly prospective studies, should extend research on SSS and health to further countries/ethnic groups, also considering additional psychological and biological mediators and dynamic aspects of SSS. Recently developed experimental approaches to manipulate SSS may also be promising.