Exploring the Co-Occurrence of Depressive Symptoms and Aggression among Chinese Adolescents: Patterns and Stability

Depressive symptoms and aggression frequently occur together, and this co-occurrence may result in more severe developmental problems. However, it is unclear if there are distinct patterns of co-occurrence. This study investigated the co-occurrence patterns of depressive symptoms and aggression, and examined their stability and demographic characteristics. A total of 1010 Chinese adolescents (50.6% girls; mean age at T1 = 12.54 years, SD = 0.42) participated in annual surveys over three years (2019-2021). Three different patterns of co-occurrence were found except for the normal group: depression-dominant co-occurrence (13.6%), aggression-dominant co-occurrence (3.2%), and moderate co-occurrence (6.0%) (T1). In these co-occurrence patterns, adolescents classified as aggression-dominant co-occurrence exhibited the most instability and frequent changes, while adolescents classified as depression-dominant co-occurrence exhibited the most stability. Boys or younger adolescents were more likely to exhibit the aggression-dominant co-occurrence, while girls or older adolescents were more likely to exhibit the depression-dominant co-occurrence. The findings indicate that the co-occurrence patterns observed are distinct and are dominated by aggression or depression, which implies the need for targeted intervention practices.

Social transition, socioeconomic status and self-rated health in China: evidence from a national cross-sectional survey (CGSS)

Background

Social transition is one of the multi-level mechanisms that influence health disparities. However, it has received less attention as one of the non-traditional social determinants of health. A few studies have examined China's social transition and its impact on health inequality in self-rated health (SRH). Therefore, this study explores the impact of China's market-oriented reforms-social transition and socioeconomic status (SES)-on residents' SRH.

Methods

Using the cross-sectional data from the Chinese General Social Survey (CGSS) in 2017, we analyzed the effects of social transition and SES on the SRH of Chinese residents using the RIF (Recentered influence function) method. The RIF decomposition method investigated health differences among different populations and their determinants.

Results

Social transition and SES have significant positive effects on the SRH of Chinese residents. The correlation between SES and the SRH of Chinese residents is moderated by social transition, implying that social transition can weaken the correlation between SES and the SRH of Chinese residents. The impacts of SES and social transition on SRH vary across populations.

Conclusion

Promoting social transition and favoring disadvantaged groups with more resources are urgently needed to promote equitable health outcomes.

The Status Importance Scale: Development and validation of a self-report questionnaire for measuring how much people care about status

Although substantial research indicates that considerations about status can lead to anxiety and other negative outcomes, a valid measure of the importance individuals attribute to status is lacking. This paper introduces the Status Importance Scale (SIS), a mono-factorial 10-item self-report questionnaire that quantifies how important a person deems status to be. Five studies validate the scale showing that it has excellent internal reliability and acceptable test-retest reliability, it correlates with several related measures (supporting convergent validity), it shows little correlation with theoretically unrelated constructs (supporting discriminant validity), it is the best predictor of conspicuous consumption compared with other potential candidates (supporting concurrent validity), and it can help predicting which activities one gives importance to (further supporting concurrent validity). Finally, as hypothesized by previous literature, the last study reveals that the SIS can predict status anxiety. The SIS can contribute to research regarding important phenomena such as the detrimental psychological effects of income inequality.

Intersectionality on the perception of health in two cross-national surveys (WVS and EVS)

This article focuses on the health perceptions of people across social strata and nations using the combined dataset of the World Values Survey and the European Values Study (EVS/WVS). An intercategorical intersectional analysis model was developed to examine the social determinants underlying differences in health perceptions. Using logistic regression of the interactions between sex, age, level of educational attainment and income, we calculated the impact of these variables (main effects) and their interactions within the intersecting categories on health perceptions. The group with the best perception of their health includes men aged 16-49, with a high income and an upper-middle level of education. Comparative analysis has been carried out to identify differences in the influence of intersectional categories across countries. Of particular relevance is the number of Eastern European countries where the perception of people aged 50 and over with low income is very poor.

Do housing prices affect individual physical health? Evidence from China

This study identifies the health effect of rising housing prices on individual physical health using the Chinese General Social Survey (CGSS) data. Exploiting exogenous housing prices, I find that rising housing prices adversely affect physical health status. Heterogeneity analyses yield interesting findings. First, the adverse effects of high housing prices are pronounced in the group owning only one house. Second, significant effects of housing prices on health for the group aged 20 to 45 are observed, with no effects for the elderly group above 45. Third, males are more sensitive to high housing prices due to the intensified competition and traditional gender norm in marriage markets. I also further investigate the channel through which housing prices affect individual physical health. The findings indicate that rising housing prices can damage individual physical health via lowering social status, reducing physical exercise time and increasing mental health risk.

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.

The British Columbia Farmers' Market Nutrition Coupon Program Reduces Short-Term Household Food Insecurity Among Adults With Low Incomes: A Pragmatic Randomized Controlled Trial

BACKGROUND

The British Columbia Farmers' Market Nutrition Coupon Program (BC FMNCP) provides households with low incomes with coupons to purchase healthy foods from farmers' markets.

OBJECTIVE

To examine the impact of the BC FMNCP on the short-term household food insecurity, malnutrition risk, mental well-being, sense of community (secondary outcomes), and subjective social status (exploratory outcome) of adults with low incomes post-intervention and 16 weeks post-intervention.

DESIGN

Secondary analyses from a pragmatic randomized controlled trial conducted in 2019 that collected data at baseline, post-intervention, and 16 weeks post-intervention.

PARTICIPANTS/SETTING

Adults ≥18 years with low incomes were randomized to an FMNCP group (n = 143) or a no-intervention control group (n = 142).

INTERVENTION

Participants in the FMNCP group received 16 coupon sheets valued at $21 Canadian dollars (CAD)/sheet over 10 to 15 weeks to purchase healthy foods from farmers' markets and were eligible to participate in nutrition skill-building activities.

MAIN OUTCOME MEASURES

Outcomes included short-term household food insecurity (modified version of Health Canada's 18-item Household Food Security Survey Module), malnutrition risk (Malnutrition Universal Screening Tool), mental well-being (Warwick-Edinburgh Mental Well-Being Scale), sense of community (Brief Sense of Community Scale), and subjective social status (MacArthur Scale of Subjective Social Status community scale).

STATISTICAL ANALYSIS

Mixed-effects linear regression and multinomial logistic regression examined between-group differences in outcomes post-intervention and 16 weeks post-intervention.

RESULTS

The risk of marginal and severe short-term household food insecurity was lower among those in the FMNCP group compared with those in the control group (relative risk ratio [RRR] 0.15, P = 0.01 and RRR 0.16, P = 0.02) post-intervention, with sustained reductions in severe household food insecurity 16 weeks post-intervention (RRR 0.11, P = 0.01). No statistically significant differences were observed in malnutrition risk, mental well-being, sense of community, or subjective social status post-intervention or 16 weeks post-intervention.

CONCLUSIONS

The BC FMNCP reduced short-term household food insecurity but was not found to improve malnutrition risk or psychosocial well-being among adults with low incomes compared with a no-intervention control group.

Psychosocial stressors associated with frailty in community-dwelling older adults in the United States

BACKGROUND

Frailty is multifactorial; however, psychosocial stressors contributing to frailty are poorly understood. This study aimed to examine whether gender, race/ ethnicity, and education are associated with differential exposure to psychosocial stressors, determine psychosocial stressors contributing to frailty, and explore the mediating psychosocial stressors pathway.

METHODS

This cross-sectional study involved 7679 community-dwelling older adults (≥65) from the Health and Retirement Study (2006 and 2008 waves). Psychosocial stressors such as loneliness, low subjective social status, financial strain, poor neighborhood cohesion, everyday discrimination, and traumatic life events were measured. Frailty was defined by the Fried phenotype measure. Multivariable logistic regressions were used to examine the association of gender, race/ethnicity, and education with psychosocial stressors, psychosocial stressors associated with frailty, and the mediating psychosocial stressors pathway.

RESULTS

Females experienced greater financial strain but lower discrimination (both p < 0.05). Older adults who identified as Hispanic, Black, and racially or ethnically minoritized experienced low subjective social status, high financial strain, low neighborhood cohesion, and high discrimination than their White counterparts (all p < 0.05). Those with lower education experienced high loneliness, low subjective social status, high financial strain, low neighborhood cohesion but lower traumatic life events (all p < 0.05). Psychosocial stressors: High loneliness, low subjective social status, high financial strain, and low neighborhood cohesion (all p < 0.05) independently increased the odds of frailty. The mediating pathway of psychosocial stressors was not significant.  CONCLUSION: Disparities exist in exposure to psychosocial stressors associated with frailty. Multilevel interventions are needed to reduce the influence of psychosocial stressors on frailty.

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

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

Perceived social position, active engagement with life, and depressive symptoms among older adults

RATIONALE

Despite the existing literature on the relationship between perceived social position (PSP) and depressive symptoms, there remain gaps in our understanding, particularly regarding the potential for asymmetric effects of increases and decreases in PSP and the underlying mechanisms involved.

OBJECTIVE

This study aims to examine whether increases and decreases in PSP are differentially associated with depressive symptoms and to explore the potential mediating role of active engagement with life in these associations.

METHODS

This study utilized data from the Korean Longitudinal Study of Aging (KLoSA), collected between 2008 and 2018, involving a sample of 3506 individuals aged 65 or older. Asymmetric fixed effects (FE) models were employed, which enable the estimation of differential effects for increases and decreases in PSP, while accounting for unobserved individual-level heterogeneity. To assess the mediating role of active engagement in life, Sobel mediation tests were conducted.

RESULTS

The asymmetric FE estimates revealed a stronger association between decreases in PSP and increases in depressive symptoms compared to the association between increases in PSP and decreases in depressive symptoms. The Sobel mediation tests indicated that formal social activities had the most substantial mediating effect, explaining 14% and 9% of the total effect mediated for increased and decreased PSP and depressive symptoms, respectively. Leisure/hobby activities explained 10% and 4% of the total effect mediated for increased and decreased PSP and depressive symptoms, respectively.

CONCLUSION

This study provides evidence that increases and decreases in PSP have differential effects on depressive symptoms among older adults in Korea. Policy interventions aimed at improving the psychological well-being of older adults should prioritize efforts to both enhance PSP and minimize declines, as the latter can have a stronger negative impact on depressive symptoms. Active engagement in life may serve as a potential pathway for achieving the desired effects.

Fear of a Black Neighborhood: Anti-Black Racism and the Health of White Americans

Does anti-Black racism harm White Americans? We advance hypotheses that address this question within the neighborhood context. Hypotheses are tested with neighborhood and survey data from a probability sample of White residents of Nashville, Tennessee. We find that regardless of neighborhood crime rates or socioeconomic compositions, Whites report heightened perceptions of crime and danger in their neighborhoods as the proportion of Black residents increases. Perceived neighborhood danger, in turn, predicts increased symptoms of psychophysiological distress. When stratified by socioeconomic status (SES), however, low-SES Whites also report perceptions of higher status when living near more Black neighbors, which entirely offsets their distress. We conclude that although anti-Black racism can ironically harm the health of White Americans, compensatory racist ideologies can also offset these harms, particularly for lower-status Whites. We situate our findings within broader discussions of anti-Black racism, residential segregation, and psychiatric disorders commonly observed among White Americans.

The socioeconomic consequences of loneliness: Evidence from a nationally representative longitudinal study of young adults

The negative health consequences of loneliness have led to increasing concern about the economic cost of loneliness in recent years. Loneliness may also incur an economic burden more directly, by impacting socioeconomic position. Much of the research to date has focused on employment status which may not fully capture socioeconomic position and has relied on cross-sectional data, leaving questions around the robustness of the association and reverse causation. The present study used longitudinal data to test prospective associations between loneliness and multiple indicators of social position in young adulthood, specifically, whether participants who were lonelier at age 12 were more likely to be out of employment, education and training (NEET) and lower on employability and subjective social status as young adults. The data were drawn from the Environmental Risk (E-Risk) Longitudinal Twin Study, a birth cohort of 2,232 individuals born in England and Wales during 1994-1995. Loneliness and subjective social status were measured at ages 12, 18 and 26. Employability and NEET status were assessed at age 18. Findings indicate that greater loneliness at age 12 was prospectively associated with reduced employability and lower social status in young adulthood. The association between loneliness and lower social status in young adulthood was robust when controlling for a range of confounders using a sibling-control design. Results also indicate that loneliness is unidirectionally associated with reduced subjective social status across adolescence and young adulthood. Overall, our findings suggest that loneliness may have direct costs to the economy resulting from reduced employability and social position, underlining the importance of addressing loneliness early in life.

Dietary Adherence Is Associated with Perceived Stress, Anhedonia, and Food Insecurity Independent of Adiposity

We examined whether perceived stress, anhedonia, and food insecurity were associated with dietary adherence during a 6-week intervention. Sixty participants (23 m; 53 ± 14 y) completed psychosocial measures and were provided with full meals. Individuals with obesity were randomized to a weight-maintaining energy needs (WMENs) (n = 18; BMI 33 ± 4) or a 35% calorie-reduced diet (n = 19; BMI 38 ± 9); normal-weight individuals (n = 23; BMI 23 ± 2) were assigned to a WMENs diet. Adherence scores were determined via weekly assessments and daily ecological momentary assessments (EMAs) of real-time behavior in a natural environment. Perceived stress and anhedonia were associated with % body fat (all r-values > 0.25, all p-values < 0.05), but food insecurity and adherence were not. Higher perceived stress (r = -0.31, p = 0.02), anhedonia (r = -0.34, p = 0.01), and food insecurity (r = -0.27, p = 0.04) were associated with lower adherence scores, even after adjusting for age, sex, and % body fat. In all adjusted models, % body fat was not associated with adherence. Higher measures of stress, anhedonia, and food insecurity predicted lower adherence independently of body fat, indicating that psychosocial factors are important targets for successful adherence to dietary interventions, regardless of body size.

The heterogeneous well-being effects of intergenerational mobility perceptions

Individuals make comparisons with their parents which determine their intergenerational mobility perceptions, yet very little is known about the areas used for intergenerational comparison and whether these matter for individuals' well-being. In 2021 we commissioned a nationally representative survey in Georgia in which we explicitly asked 1159 individuals an open-ended question on the most important areas in their intergenerational comparisons. More than 170 types of answers were provided by respondents and many of these responses went beyond the standard indicators of intergenerational mobility. We show that the areas of intergenerational comparison significantly differ between those who perceive themselves as being downwardly and upwardly mobile or immobile using the measure of mobility previously validated in cross-national research. Using, among other statistical approaches, treatment effects estimators, we demonstrate that some areas of intergenerational comparison, particularly in terms of income attainment, are significantly and consistently associated with internationally validated measures of well-being.

A longitudinal study of perceived social position and health-related quality of life

BACKGROUND

A large body of evidence suggests that there is a social gradient in the association between perceived social position and various health outcomes. Yet only a fraction of this research uses longitudinal data, and these studies usually rely on two data points in time, consider a single health outcome measure, overlook non-linear effects of perceived social position, and come almost exclusively from the Western welfare democracies.

METHODS

Using data for 1921 individuals from three waves (2008, 2013, 2018) of the Polish Panel Survey (POLPAN), we fit between- and within-individuals hybrid-effects models with cluster-robust standard errors to investigate the association between one's perceived social position (self-placement on a socioeconomic hierarchy scale varying 1 to 10) and subsequent health-related quality of life (HRQoL) measured using the Nottingham Health Profile (NHP) and its six components.

RESULTS

We find that the association between perceived social position and health-related quality of life is larger when estimated between individuals than within individuals, yet in fixed- and hybrid-effects models perceived social position remains significantly and negatively linked with both the aggregated NHP measure as well as with its components such as emotional reaction, physical abilities, sleep, and social isolation. We also identify that starting to perceive oneself at the lower end of the social hierarchy is associated with a deteriorating health-related quality of life but a change at the top of the perceived social hierarchy is not linked with an improvement in NHP scores.

CONCLUSIONS

We provide new evidence on the significant and non-linear links between perceived social position and health-related quality of life and highlight possible pathways linking these two aspects of individuals' lives.

Subjective socioeconomic status and self-rated health in the English Longitudinal Study of Aging: A fixed-effects analysis

Higher subjective socio-economic status (SES) goes along with better self-rated health: This finding is well-established in the literature, yet the majority of studies it is based on only rely on cross-sectional analyses and only account for few potential confounders of the association. Particularly wealth, which is increasingly thought of as an important dimension of accumulated advantage, is only rarely examined as a confounder. Using eight waves of panel data from the English Longitudinal Study of Aging (ELSA, 2002-19), we investigate the association between subjective SES and self-rated health. We use random effects models that account for theoretically important time-constant (such as education and social class) and time-varying confounders (such as income and wealth) as well as fixed-effects models, that in addition control for all time-constant confounders, whether observed or unobserved. The fully adjusted fixed-effects model reveals a statistically significant association between subjective SES and self-rated health. Yet, a one-point increase on the subjective SES ladder goes along with a two per cent of a standard deviation increase in self-rated health, only around a quarter of the size of the random-effects estimate. The role of wealth for the subjective SES-self-rated health association is negligible in the fixed-effects specifications. Smoking, drinking, and physical activity do not appear to mediate the association. A substantial part, though not all, of the observed association between subjective SES and self-rated health is due to unobserved confounding rather than a causal effect. Reducing health inequalities based on objective SES is likely more effective than based on subjective SES.

Modelling the effect of demographic change and healthcare infrastructure on the patient structure in German hospitals - a longitudinal national study based on official hospital statistics

BACKGROUND

Effects of demographic change, such as declining birth rates and increasing individual life expectancy, require health system adjustments offering age- and needs-based care. In addition, healthcare factors can also influence health services demand.

METHODS

The official German hospital statistics database with odd-numbered years between 1995 and 2011 was analysed. This is a national comprehensive database of all general hospital inpatient services delivered. Official data from hospital statistics were linked at the district level with demographic and socio-economic data as well as population figures from the official regional statistics. Panel data regression, modelling case numbers per hospital, was performed for 13 diagnosis groups that characterised the patient structure. Socio-demographic variables included age, sex, household income, and healthcare factors included bed capacity, personnel and hospital characteristics.

RESULTS

The median number of annual treatments per hospital increased from 6 015 (5th and 95th percentile [670; 24 812]) in 1995 to 7 817 in 2011 (5th and 95th percentile [301; 33 651]). We developed models characterising the patient structure of health care in Germany, considering both socio-demographic and hospital factors. Demographic factors influenced case numbers across all major diagnosis groups. For example, the age groups 65-74 and 75 + influenced cerebrovascular disease case numbers (p < 0.001). Other important factors included human and material resources of hospitals or the household income of patients. Distinct differences between the models for the individual diagnosis groups were observed.

CONCLUSIONS

Hospital planning should not only consider demographic change but also hospital infrastructure and socio-economic factors.

Exploring the relationship between multiple dimensions of subjective socioeconomic status and self-reported physical and mental health: the mediating role of affect

Introduction

This study aimed to investigate the predictive effects of two types of subjective socioeconomic status on self-reported physical and mental health. Specifically, we examined the MacArthur Scale (MacArthur) which measures perceived socioeconomic rank in the society and a novel scale called ComSim, which assessed how participants compared themselves socioeconomically to others coming from a similar socioeconomic background. We also considered the influence of income, education, and personal relative deprivation (PRD) in these analyses. Additionally, we explored whether these effects were mediated through negative and positive affect.

Methods

The data were collected through a cross-sectional, two-wave survey of 294 women and 294 men, with a mean age 41.6 years. Participants were recruited via an online platform.

Results

The results from multivariate regression models revealed that socioeconomic status measured with both the MacArthur Scale and ComSim significantly predicted both self-reported health measures, whereas income and education did not predict any of these measures in the full multivariate models. PRD only predicted self-reported mental health. Mediation analyses showed that negative and positive affect mediated the relationships between socioeconomic status measured by ComSim and self-reported health measures.

Discussion

These findings are discussed in the context of the similarity hypothesis of social comparison theory. The results underscore the importance of considering multiple dimensions when examining socioeconomic health disparities.

Lower socioeconomic status is related to poorer emotional well-being prior to academic exams

BACKGROUND

People of lower social status tend to have greater emotional responses to stress. The present study assessed whether lower social status was related to greater emotional responses in anticipation of a naturalistic stressor: academic exams among college students.

METHODS

College students in an introductory statistics class (N = 252; 75.81% female; 18.41% Latino, 25.10% White, 43.93% Asian, 12.56% different racial backgrounds) completed two course exams as part of this naturalistic prepost-experimental design. They provided four reports of positive, depressive, and anxious emotion - one the day before and one immediately after each exam.

RESULTS

As hypothesized, multilevel models (ratings nested within participants) predicting emotion indicated that students with lower mother's education had less positive emotion, more depressive emotion, and more anxious emotion the day prior to academic exams than students with higher mother's education (proportional reductions in variance [PRV] = .013-.020). Specifically, lower mother's education was associated with poorer well-being before but not after the exam. Exploratory models revealed that differences in emotion by mother's education were strongest for students with lower exam scores (PRV = .030-.040).

CONCLUSIONS

Socioeconomic status may influence college students' anticipatory distress prior to academic exams, which may impact health and academic performance.

The influence of subjective socioeconomic status on executive functions in middle-aged and older adults

Subjective socioeconomic status (SES) has been shown to influence both psychological and biological outcomes. However, less is known about whether its influence extends to cognitive outcomes. We examined the relation between subjective SES and executive functions (EF)-a set of cognitive control processes-and its underlying mechanisms. By analyzing a nationally representative cohort of middle-aged and older adults (age 40-80) from the MIDUS 2 National Survey and Cognitive Project, we tested a serial mediation model with sense of control and health as sequential mediators. Using structural equation modeling, we found that subjective SES is indirectly related to EF via sense of control and health, above and beyond objective SES and other key covariates. Our study highlights one of the possible biopsychosocial mechanisms that underlies the relation between status-related subjective perceptions of inequalities and executive functioning skills in middle and late adulthood.

Socioeconomic status and social anxiety: attentional control as a key missing variable?

BACKGROUND AND OBJECTIVES

The aim was to examine the role of attentional control as a psychological factor involved in socioeconomic status-related mental health differences, and specifically in social anxiety. Based on the literature on socioeconomic status differences in cognitive abilities and attentional control theory, we hypothesized that attentional control would account for the relation between socioeconomic status and social anxiety. We tested this hypothesis in an integrative model also including trait anxiety and subjective socioeconomic status.

DESIGN

Cross-sectional.

METHOD

Online, 439 French adults were recruited via social media. They completed self-reported measures of attentional control, objective socioeconomic status, subjective socioeconomic status, social anxiety, and trait anxiety.

RESULTS

Using Structural Equation Modelling, findings showed a positive association between objective (but not subjective) socioeconomic status and attentional control, which in turn was related to social anxiety. Exploratory analyses showed that only income, as objective socioeconomic status indicator, was associated with attentional control.

CONCLUSIONS

The current study is the first to support that low socioeconomic status individuals report less attentional control and more social anxiety symptoms. This suggests that attentional control is a psychological factor involved in social anxiety inequalities.

Importance of caregivers' subjective social status and neighbourhood disadvantage for adolescents with type 1 diabetes

AIMS

Adolescents with type 1 diabetes from low-income populations are more likely to have difficulty in managing their diabetes and ultimately have poorer glycaemic outcomes, but less is known about neighbourhood-level factors or subjective social status (SSS) as risk/protective factors. We examined associations between multiple indicators of socio-economic status with diabetes outcomes.

METHODS

One hundred and ninety-eight adolescents ages 13-17 (58% female, 58% White, non-Hispanic) experiencing moderate diabetes distress completed measures of diabetes management and diabetes distress, and their caregivers reported on SSS. Glycaemic indicators were extracted from medical records, and participants' addresses were used to determine area deprivation index (ADI).

RESULTS

Higher levels of neighbourhood disadvantage were significantly associated with higher haemoglobin A1c levels and average glucose levels, but caregivers' SSS was more strongly associated with all glycaemic indicators, diabetes management and diabetes distress.

CONCLUSIONS

Given strong associations between caregivers' SSS and glycaemic control, diabetes management, and diabetes distress, screening for caregivers' SSS may identify adolescents who would benefit from additional support.

Does gender moderate the association between socioeconomic status and health? Results from an observational study in persons with spinal cord injury living in Morocco

Background

Socioeconomic status (SES) and gender are well-known social determinants of health. However, their impact on health in populations with physical disabilities in low-resource countries is still lacking. Therefore, the objective of this study was to investigate associations of individual SES with health and the moderating effect of gender on this association in a Moroccan population with a physical disability, namely spinal cord injury.

Methods

Cross-sectional survey data from 385 participants with spinal cord injury living in Morocco were analyzed. SES was operationalized by education level, household income, financial hardship, and subjective social status. Health indicators included secondary conditions, pain, vitality, quality of life, and general health. Associations between SES and health indicators were investigated using linear and logistic regressions. To test the potential moderation of gender, interaction terms between SES and gender were introduced in regression models.

Results

Financial hardship and lower subjective social status were associated with poorer health outcomes in four out of five indicators in the total sample. In contrast, education and income were inconsistently associated with health. Overall, gender did not moderate the association between SES and health, except that educational inequalities in general health were more pronounced in women, and the observation of a trend for a stronger negative effect of subjective social status on men's than woman's health (p &gt; 0.05).

Conclusion

This study revealed that subjective indicators of SES negatively impact on health, whereas evidence for the moderating role of gender in this association was weak. These findings underline the importance to reduce social marginalization and poverty in populations with disabilities in low-resource countries to reduce their double burden of living with a disability and encountering social disadvantages through low SES.

Subjective social status and health among older adults in China: the longitudinal mediating role of social trust

BACKGROUND

From a developmental perspective, this study explored the interplays between subjective social status (SSS), social trust (ST), and health status measured by self-rated health (SRH) among older adults in the context of China. It also tested the longitudinal mediation of ST between SSS and SRH.

METHODS

After excluding samples with missing values, we analyzed 4,877 individual responses from those aged 60 years or older, extracted from the China Family Panel Studies (CFPS) data in 2014, 2016, and 2018. We used latent growth modeling to test the hypothesized relationships among their SSS, ST, and SRH.

RESULTS

Latent growth modeling based on bootstrapping showed that the SSS, ST, and SRH of older adults all increased linearly and that the mechanism of SSS acted on the SRH as follows: the initial level of SSS indirectly influenced the initial level and the growth rate of the SRH, respectively, through the initial level of ST, and the initial level and growth rate of SSS played an indirect role in the growth rate of the SRH through the growth rate of ST.

CONCLUSION

The findings have practical implications for promoting health for older adults and realizing active aging in China. Therefore, we recommend establishing a family-centered and community-supported social support system for those with lower social status among older adults and a friendly community environment with various social, cultural, and recreational activities to improve the ST among older adults, thereby improving their health.

Turning their backs on the 'ladder of success'? Unexpected responses to the MacArthur Scale of Subjective Social Status

Subjective social status measures a person's perception of their social class relative to other people and has theoretically and empirically been positively associated with health and wellbeing. A widely used measure of this construct is the MacArthur Scale of Subjective Social Status, which asks people to report their social status by placing themselves on a ladder which represents the social hierarchy of their society or community; the scale has been used with many different populations across many countries. In this research note, we describe two cases where we encountered unexpected reactions to the MacArthur Scale that we believe highlight (a) the salience of relative social status for people's wellbeing in contemporary society and (b) the concomitant sensitivities raised by measuring this subjective experience. We discuss the implications of these observations for future research.

Persistent COVID-19 symptoms in community-living older adults from the Canadian Longitudinal Study on Aging (CLSA)

BACKGROUND

Symptom persistence in non-hospitalized COVID-19 patients, also known as Long COVID or Post-acute Sequelae of COVID-19, is not well characterized or understood, and few studies have included non-COVID-19 control groups.

METHODS

We used data from a cross-sectional COVID-19 questionnaire (September-December 2020) linked to baseline (2011-2015) and follow-up (2015-2018) data from a population-based cohort including 23,757 adults 50+ years to examine how age, sex, and pre-pandemic physical, psychological, social, and functional health were related to the severity and persistence of 23 COVID-19-related symptoms experienced between March 2020 and questionnaire completion.

RESULTS

The most common symptoms are fatigue, dry cough, muscle/joint pain, sore throat, headache, and runny nose; reported by over 25% of participant who had (n = 121) or did not have (n = 23,636) COVID-19 during the study period. The cumulative incidence of moderate/severe symptoms in people with COVID-19 is more than double that reported by people without COVID-19, with the absolute difference ranging from 16.8% (runny nose) to 37.8% (fatigue). Approximately 60% of male and 73% of female participants with COVID-19 report at least one symptom persisting >1 month. Persistence >1 month is higher in females (aIRR = 1.68; 95% CI: 1.03, 2.73) and those with multimorbidity (aIRR = 1.90; 95% CI: 1.02, 3.49); persistence >3 months decreases by 15% with each unit increase in subjective social status after adjusting for age, sex and multimorbidity.

CONCLUSIONS

Many people living in the community who were not hospitalized for COVID-19 still experience symptoms 1- and 3-months post infection. These data suggest that additional supports, for example access to rehabilitative care, are needed to help some individuals fully recover.

Subjective social status and allostatic load among older people in England: A longitudinal analysis

BACKGROUND

Subjective social status has a known association with health, whereby better health outcomes are observed for those with higher perceived status. In this research, we offer new evidence on the status-health relationship using a rigorous methodological approach that considers both observed and unobserved confounders.

METHODS

We use 5 waves of data spanning 15 years from the English Longitudinal Study of Ageing and derive a measure of allostatic load with biomarkers as an objective measure of health. We apply 'within-between' panel regression models.

RESULTS

Models reveal the expected association between subjective status and health when comparing participants (the 'between' estimate), but no association when examining temporal variation within participants (the 'within' estimate). When controlling for personality traits including optimism, and parental education, the 'between' association between subjective status and allostatic load is reduced but does not disappear.

CONCLUSIONS

Person-level confounders play some role in explaining the observed link between subjective status and health. The exact nature of the link, including the role of psychological pathways and early-life confounders, remains a question for future research.

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.

Turning their backs on the 'ladder of success'? Unexpected responses to the MacArthur Scale of Subjective Social Status

Subjective social status measures a person's perception of their social class relative to other people and has theoretically and empirically been positively associated with health and wellbeing. A widely used measure of this construct is the MacArthur Scale of Subjective Social Status, which asks people to report their social status by placing themselves on a ladder which represents the social hierarchy of their society or community; the scale has been used with many different populations across many countries. In this research note, we describe two cases where we encountered unexpected reactions to the MacArthur Scale that we believe highlight (a) the salience of relative social status for people's wellbeing in contemporary society and (b) the concomitant sensitivities raised by measuring this subjective experience. We discuss the implications of these observations for future research.

The role of sense of community in improving the health-related quality of life among Black Americans

Black Americans have the lowest life expectancy and health-related quality of life (HRQoL; a strong predictor of premature mortality) of any racial/ethnic group in the United States. Low rates of physical activity and engagement in healthy eating are two known contributors to low HRQoL. Black Americans are more likely to live in environments that inhibit engagement in these two contributors. The present study examined sense of community as a buffer against the adverse effects of low physical activity and healthy eating on HRQoL among Black Americans. A sample of 290 Black American adults were recruited for the present study. Results indicate that sense of community buffers against the adverse effects of low physical activity on HRQoL. The results of the present study can be used by health promotion interventionists and policy-makers to improve HRQoL and reduce premature mortality among Black Americans.

Low subjective social status is associated with daily selection of fewer healthy foods and more high-fat/high sugar foods

Socioeconomic status has been related to poorer eating behaviors, potentially due to feeling of lower status relative to peers. Despite experimental evidence that temporarily feeling of lower status can contribute to greater caloric intake, it remains unclear how feeling of lower social status relate to eating behavior in daily life. This study aimed to test whether lower subjective social status (SSS)-the feeling of having relatively lower social status-in American society and relative to college peers were related to daily food selection. A sample of 131 young adults (Mage = 20.3, SD = 0.8; 60% female; 46% Latinos; 34% European American; 15% Asian American; 5% of other ethnicities) reported their SSS in society and in college and completed 15 daily reports regarding the number of daily servings they had of fruits, vegetables, fried foods, fast foods, desserts, and sugary drinks. Multilevel models with days nested within individuals were used to test whether low SSS in society or college related to daily food intake. Next, we examined whether associations were driven by young adults' perceived stress and daily stressors. Analyses controlled for age, gender, ethnicity, family and personal income, and parents' education to test the unique associations between subjective status and food intake. Whereas SSS in society was not related to food intake, young adults with lower SSS in their college consumed fewer daily servings of healthy foods and more daily servings of high-fat/high-sugar foods. Although lower college SSS was related to greater perceived stress, perceived stress and daily stressors were consistently unrelated to daily food intake. Findings suggested that lower SSS in local environments (e.g., college) may impact young adults' daily food choices through processes beyond heightened stress.

Social determinants of memory change: A three-year follow-up of the Canadian Longitudinal Study on Aging (CLSA)

OBJECTIVES

Changes in memory can interfere with activities of daily living and may be indicative of serious health concerns such as mild cognitive impairment or dementia. Risk factors for cognitive decline and dementia have been shown to cluster around inequalities, suggesting that minority groups may be at an increased risk for cognitive decline. We sought to clarify the relationship between social determinants and change in memory function over a 3-year follow-up period, after accounting for demographic and health variables.

METHODS

We used baseline and first follow-up data from the Canadian Longitudinal Study on Aging (CLSA). Our primary analysis consisted of a multivariable linear regression model (n = 30,475). Demographic, health, education and occupation, social support, social identity, and social positioning variables (predictors) were measured at baseline. We computed a reliable change index (outcome) using the Rey Auditory Verbal Learning Test (RAVLT).

RESULTS

Older age and some health considerations (e.g., higher body mass index, low hearing) were associated with a greater decline in memory over the three-year period. In contrast, some physical activity and better self-rated general health were associated with improvements in memory. Having a hobby and better perceived social standing were associated with greater memory improvement. Social identities who experience minority stress (sexual orientation, gender identity, and race) did not predict change in memory.

DISCUSSION

Altogether, these results contribute to a growing body of evidence that points to older members of minoritized communities exhibiting initial differences in cognitive functioning (i.e., cross-sectional differences) but not more rapid cognitive aging.

The independent and joint contribution of objective and subjective socioeconomic status on oral health indicators

OBJECTIVES

The understanding of how subjective socioeconomic status (SSS) relates to objective socioeconomic status (OSS), and how both conditions act together in oral health outcomes is still unclear. This study aims to test the independent and joint association between OSS and SSS with oral health, to assess the role of socioeconomic status discrepancies, and to evaluate the role of SSS in the association between OSS and oral health.

METHODS

Data from 1140 adults from a population-based study in Southern Brazil were used. We applied diagonal reference models DRM to disentangle the effects of OSS (education) and SSS (MacArthur Scale) to oral health outcomes. The outcomes were functional dentition clinically evaluated (FD ≥20 teeth) and self-reported oral health SROH. We also examined the discrepancy between OSS and SSS to oral health indicators and the effect measure modification (EMM) of SSS on the association between OSS and oral health.

RESULTS

Subjective socioeconomic status and OSS contributed equally to SROH, while OSS explained a substantially higher amount of FD than SSS (0.85 vs 0.15). An EMM of SSS was found on the association between OSS and fair/poor SROH, with a relative excess risk due to interaction (RERI) of 1.08. Less evidence of EMM was found for FD (RERI = 0.14). Individuals with lower SSS and OSS had four times the risk of the outcomes than the reference group.

CONCLUSIONS

Adults with concordant lower SSS and OSS have a worse oral health than those with concordant higher status. There was evidence that the association between OSS and SROH is modified by SSS.

Subjective social status and nocturnal blood pressure dipping

OBJECTIVE

Low social status has been linked to cardiovascular disease. Subjective social status (SSS), which represents one's perceived position in a social hierarchy, has been suggested to predict health outcomes beyond objective measures of socioeconomic status. The present study examined if lower SSS is related to reduced nocturnal blood pressure (BP) dipping, a risk factor for cardiovascular disease.

METHODS

In this cross-sectional study, a community sample of 53 healthy adults underwent 24-h ambulatory BP monitoring. All participants provided information on SSS and objective measures of socioeconomic status (i.e., education, occupation, and income). SSS was measured in comparison to others in the country (national SSS) as well as in comparison to one's social environment (local SSS) using the German versions of the MacArthur Scales.

RESULTS

Analyses found that participants with low local SSS exhibited attenuated nocturnal diastolic blood pressure dipping (β = 0.29, 95% CI [0.01, 0.57], p = .043) and mean arterial pressure dipping (β = 0.29, 95% CI [0.01, 0.57], p = .041). These associations remained significant after adjusting for objective socioeconomic status. No significant associations between national SSS and cardiovascular measures were observed.

CONCLUSION

In conclusion, one's perceived social position in the social environment (i.e., local SSS) is associated with nocturnal BP dipping. Therefore, local SSS may be an important psychosocial factor linking social inequality and cardiovascular health.

Skin Tone and the Health Returns to Higher Status

This study addresses two questions. First, why do Black Americans exhibit worse health outcomes than White Americans even at higher levels of socioeconomic status (SES)? Second, are diminished health returns to higher status concentrated among Black Americans with darker skin color? Novel hypotheses are tested with biosocial panel data from Add Health, a nationally representative cohort of Black and White adolescents who have transitioned to adulthood. We find that White and light-skin Black respondents report improved health after achieving higher SES, on average, while their darker-skin Black peers report declining health. These patterns persist regardless of controls for adolescent health status and unmeasured between-person heterogeneity. Moreover, increased inflammation tied to unfair treatment and perceptions of lower status helps to account for patterns of diminished health returns for dark-skin Black groups. Our study is the first to document skin tone heterogeneity in diminished health returns and one of few studies to identify life course stress processes underlying such disparities. We consider additional processes that could be examined in future studies, as well as the broader health and policy implications of our findings.

Fear of movement and its associated psychosocial factors in heart failure patients: A cross-sectional study

AIMS

Fear of movement is a significant obstacle to daily activities, which may lead to adverse outcomes in patients with heart failure. This study aimed to examine the prevalence of fear of movement and to identify psychosocial factors associated with fear of movement in heart failure patients.

METHODS AND RESULTS

In this cross-sectional study, a total of 305 heart failure patients were recruited from three cardiovascular units of a university hospital. Self-reported questionnaires were used to measure fear of movement, cardiac anxiety, depressive symptoms, subjective social status, education, monthly income, and employment status. The results showed that 178 (58.4%) patients were accompanied with fear of movement. Hierarchical linear regression analysis showed that scores for cardiac anxiety (β=0.254, p < 0.001) and depressive symptoms (β=0.308, p < 0.001), as well as being employed (β=0.186, p < 0.001) were positively associated with fear of movement score, while the score for subjective social status (β=-0.101, p = 0.038) was negatively associated with fear of movement score. The four independent variables accounted for 30.3% of the variance in fear of movement.

CONCLUSIONS

Fear of movement is common in patients with heart failure. Cardiac anxiety, depressive symptoms, subjective social status, and employment status were associated with patients' fear of movement. This indicates that measures should be taken to screen and manage patients' fear of movement. Furthermore, alleviating cardiac anxiety and depressive symptoms may be important to consider in relieving fear of movement in heart failure patients, especially for those who are employed and with low subjective social status.

Hypertension and Diabetes Status by Patterns of Stress in Older Adults From the US Health and Retirement Study: A Latent Class Analysis

Background

Hypertension and diabetes disproportionately affect older non‐Hispanic Black and Hispanic adults in the United States. Chronic stress may partially explain these disparities. This study identified underlying stress profiles of older US adults, analyzed stress profiles in relation to hypertension and diabetes, examined the distribution of stress profiles by race and ethnicity, and assessed patterns of change in latent classes of stress over time.

Methods and Results

Latent class analysis was conducted with a nationally representative sample of older US adults who completed 3 waves of the HRS (Health and Retirement Study) (ie, 2010 [n=6863], 2014 [n=4995], and 2018 [n=3089]). Latent classes of stress in 2010 (ie, stress profiles) were identified using 15 indicators of unmet needs within 5 categories (ie, physiological, safety/security, belonging, esteem, and self‐fulfillment). Hypertension and diabetes status were examined as outcomes of latent class membership at 3 time points, and race and ethnicity were examined in association with class membership, adjusting for sociodemographic covariates. Finally, a latent transition analysis examined the stability of latent class membership and racial and ethnic differences in the patterns of stress profiles experienced from 2010 to 2018. Five classes were identified: Generally Unmet Needs (13% of sample), Generally Met Needs (42% of sample), Unmet Self‐Efficacy/Goal Needs (12% of sample), Unmet Financial Needs (20% of sample), and Unmet Social Belonging Needs (13% of sample). Compared with the Generally Met Needs class, the Generally Unmet Needs class had higher odds of hypertension (odds ratio [OR], 1.80; [95% CI, 1.35–2.39]) and diabetes (OR, 1.94; [95% CI, 1.45–2.59]), and the Unmet Financial Needs class had higher odds of diabetes (OR, 1.50; [95% CI, 1.10–2.05]). Non‐Hispanic Black participants compared with non‐Hispanic White participants had higher odds of being members of the Generally Unmet Needs, Unmet Self‐Efficacy/Goal Needs, and Unmet Financial Needs classes (OR, 2.70; [95% CI, 1.59–4.58]; OR, 1.99; [95% CI, 1.15–3.43]; and OR, 4.74; [95% CI, 3.32–6.76], respectively). Class membership remained relatively stable over time, with 93% of participants remaining in Generally Met Needs and 78% of participants remaining in Generally Unmet Needs across time points. Compared with non‐Hispanic White participants, non‐Hispanic Black participants had lower odds of Generally Met Needs class membership at any time point (OR, 0.60; [95% CI, 0.42–0.84]) and had lower odds of moving into the Generally Met Needs class and higher odds of moving into the Unmet Financial Needs class from 2010 to 2014 (OR, 0.33; [95% CI, 0.13–0.86]; and OR, 3.02; [95% CI, 1.16–7.87], respectively).

Conclusions

Underlying classes of stress based on unmet needs were associated with hypertension and diabetes status. Racial and ethnic differences were observed for both latent class membership and transitions between classes over time. Latent classes of stress associated with unmet needs, hypertension, and diabetes and the ability to transition between classes may explain the perpetuation of racial and ethnic disparities in cardiovascular health. Interventions targeting unmet needs may be used to confront these disparities.

Retrospective reports of socioeconomic disadvantage in childhood and mortality risk: are associations consistent across measures and sex?

Although prior research has established associations between childhood socioeconomic disadvantage and all-cause mortality, there is still limited research investigating (1) the consistency between subjective and objective reports of childhood socioeconomic status, (2) sex differences in the associations between childhood socioeconomic disadvantage and all-cause mortality, and (3) potential mediators within these associations. Drawing on data from the Midlife in the United States (MIDUS) cohort (N = 7425), we examined the associations between three distinct indicators of childhood socioeconomic disadvantage and all-cause mortality risk, and whether these associations differ for males and females. Among males only, lower perceived relative childhood financial status, lower levels of parents' education, and receipt of welfare during childhood were associated with excess mortality risk, adjusted for age and minority status, with adjusted hazard ratios ranging from 1.24 (95% confidence interval (CI): 1.02, 1.51) for perceived childhood financial status to 1.28 (95% CI: 1.11, 1.47) for welfare in childhood. When additionally adjusted for education, substance use, depression, and underlying health conditions, only childhood welfare status maintained an association with mortality (AHR, 1.17; 95% CI, 1.02-1.35). Mediation analyses among males revealed that education, substance use, depression, and underlying health conditions accounted for substantial proportions of these associations, ranging from 31.03 to 57.63%, across indicators of childhood socioeconomic disadvantage. Future research is needed to clarify the developmental mechanisms that lead to sex differences and identify effective strategies to intervene on the relation between childhood socioeconomic position and excess mortality risk among males.

Life Conditions as Mediators of Welfare State Effect on Mental Wellbeing among Oldest Old in Europe

Background: Mental wellbeing is formed by our daily environments, which are, in turn, influenced by public policies, such as the welfare state. This paper looks at how different aspects of life conditions may mediate the welfare state effect on mental wellbeing in oldest old age. Methods: Data were extracted from Round 6 of the European Social Survey (2012). The dataset comprised of 2058 people aged 80 years and older from 24 countries. Mediation analyses determined possible links between the welfare state, including eleven intervening variables representing life conditions and five mental wellbeing dimensions. Results: Our study confirms that the higher the level of welfare state, the better mental wellbeing, irrespective of dimension. Although several life conditions were found to mediate the welfare state effect on mental wellbeing, subjective general health, coping with income and place in society were the most important intervening variables. Conclusions: All three variables centre around supporting autonomy in the oldest old age. By teasing out how the welfare state influences mental wellbeing in the oldest old, we can better understand the many drivers of wellbeing and enable evidence informed age-friendly policy making.

Subjective social status moderates back pain and mental health in older men

OBJECTIVES

Back pain and poor mental health are interrelated issues in older men. Evidence suggests that socioeconomic status moderates this relationship, but less is known about the role of subjective social status (SSS). This study examined if the association between back pain and mental health is moderated by SSS.

METHOD

We used a sample of community-dwelling older men (≥65 years) from the Osteoporotic Fractures in Men Study (N = 5994). Participants self-reported their back pain severity and frequency over the past 12 months. SSS was assessed with the MacArthur Scale of SSS. Mental health was assessed with the SF-12 Mental Component Summary (MCS).

RESULTS

Severe back pain was associated with lower SF-12 MCS scores (p = .03). Back pain frequency was not associated with SF-12 MCS scores. SSS moderated the back pain and mental health relationship. Among men with higher national or community SSS, the association between back pain severity and SF-12 MCS scores was not significant. However, among men with lower national or community SSS, more severe back pain was associated with lower SF-12 MCS scores (p's < .001). Among those with lower national or community SSS, greater back pain frequency was also associated with lower SF-12 MCS scores (p's < .05).

CONCLUSION

Where one ranks oneself within their nation or community matters for the back pain and mental health relationship. Higher SSS may be a psychosocial resource that buffers the negative associations of severe and frequent back pain on mental health in older men.

Subjective social status and cardiometabolic risk markers in young adults

BACKGROUND

Low subjective social status (SSS), the perceived status in the social hierarchy, is associated with cardiometabolic risk in middle-aged and older adults. However, most studies are cross-sectional and very little is known about the association in adolescence and young adulthood. The aims of this study were; a) to prospectively investigate the association between SSS at ages 15 and 28 and cardiometabolic risk at age 28-30 and b) to examine if such an association was independent of smoking, physical activity and objective measures of social position.

METHODS

The study used questionnaire information at ages 15 and 28 from the West Jutland Cohort Study (N = 3681), health measurements from a sub-sample of the cohort (N = 264, age 28-30, 50% women) and information from population-based national registers. The independent variable was a measure of SSS evaluated by a 10-rung ladder scale and dichotomized at the 25th percentile of data from the cohort study population. The outcome measure was a composite score of cardiometabolic risk including measures of lipids, inflammation, blood pressure and glucose-metabolism. Co-variates included smoking, physical activity, childhood and adulthood socioeconomic position. Sex-stratified linear regression analyses were performed to evaluate the associations between SSS and cardiometabolic risk.

RESULTS

In both sexes, low SSS at age 28, but not at age 15, was significantly associated with increased cardiometabolic risk at age 28-30. Neither smoking, physical activity, childhood or adulthood objective socioeconomic position fully explained the associations.

CONCLUSION

In young adulthood, SSS was inversely related to cardiometabolic risk after accounting for smoking, physical activity and objective measures of socioeconomic position. These findings suggest that SSS could play a role in the social disparities in cardiometabolic risk in addition to traditional measures of socioeconomic position.

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.

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.

Relationships between dopamine D2/3 receptor availability and social-environmental factors in humans

Social factors are associated with psychiatric outcomes and brain function. Relationships between local population data obtained from Social Explorer analyses of the American Community Survey (2014-2018) and dopamine D2/3 receptor (D2/3R) availability were explored in this retrospective analysis of [11C]PHNO positron emission tomography (PET) imaging data (n = 70). Larger local population size and lower percentage of the population with a bachelor's degree or higher were significantly associated with higher striatal D2/3R availability, suggesting that living in a populous area with fewer educational resources may be accompanied by stressors with concomitant dopaminergic changes. Future prospective, collaborative studies are needed to better understand the precise etiology of the observed relationships.

Perceived poverty, perceived income adequacy and loneliness in Israeli young adults: Are social capital and neighbourhood capital resilience factors?

Loneliness is a severe risk factor that has been linked to diminished health outcomes and low quality of life across ages. Young adults have been identified as a high-risk group for experiencing loneliness, but only a few studies have explored the economic and social determinants of loneliness in this age group. Taking a social inequality approach to health, with loneliness as a focus, this study examined: (a) the associations between the following factors - subjective social status (SSS) indicators (perceived poverty and perceived income adequacy), offline and online social capital, and neighbourhood capital - and loneliness; and (2) whether social and neighbourhood capital were moderators in the association between SSS and loneliness. Cross-sectional data for individuals aged 20-29 were taken from the 2017 Israeli Social Survey (N = 1,508). Employing multinomial logit models, we found that perceived poverty was a strong predictor of loneliness. Greater social and neighbourhood capital decreased loneliness, whereas a higher use of online social networks increased loneliness. Neighbourhood capital and perceived trust were moderators, whereas trust was a resilience factor, neighbourhood capital strengthened the negative effect of perceived poverty on loneliness. To reduce the prevalence of loneliness in young adults, policymakers should examine various means of enhancing social and neighbourhood capital along with moderating the use of online social networks. However, they should be aware that interventions of this kind can do little to buffer the strong effect of perceived poverty on loneliness, as in most cases the effect of perceived poverty on the probability of loneliness is not ameliorated by improved social or neighbourhood resources.

Subjective Socioeconomic Status, Cognitive Abilities, and Personal Control: Associations With Health Behaviours

Objective

To examine subjective and objective socioeconomic status (SSES and OSES, respectively) as predictors, cognitive abilities as confounders, and personal control perceptions as mediators of health behaviours.

Design

A cross-sectional study including 197 participants aged 30–50 years, recruited from the crowd-working platform, Prolific.

Main Outcome Measure

The Good Health Practices Scale, a 16-item inventory of health behaviours.

Results

SSES was the most important predictor of health behaviours (beta = 0.19, p &lt; 0.01). Among the OSES indicators, education (beta = 0.16, p &lt; 0.05), but not income, predicted health behaviours. Intelligence (r = −0.16, p &lt; 0.05) and memory (r = −0.22, p &lt; 0.01) were negatively correlated with health-promoting behaviours, and the effect of memory was upheld in the multivariate model (beta = −0.17, p &lt; 0.05). Personal control perceptions (mastery and constraints) did not act as mediators.

Conclusion

SSES predicted health behaviours beyond OSES. The effect of socioeconomic indicators was not confounded by cognitive abilities. Surprisingly, cognitive abilities were negatively associated with health-promoting behaviours. Future research should emphasise SSES as a predictor of health behaviours. Delineating the psychological mechanisms linking SSES with health behaviours would be a valuable contribution toward improved understanding of socioeconomic disparities in health behaviours.

Does perceived social mobility affect health? Evidence from a fixed effects approach

RATIONALE

The question as to whether changing one's socioeconomic position over the life course affects health has not been answered in a conclusive manner. At the same time, it has been established that individuals who think of themselves that they are higher in the social hierarchy are healthier than those who think otherwise.

OBJECTIVE

In this study, we focus on perceived social mobility to shed new light on the issue of how social mobility affects health. We examine whether perceived social mobility, i.e., an individual's appraisal of doing better or worse than their parents, affects health by analyzing longitudinal data from Poland.

METHODS

Using a fixed effects approach to account for all time-invariant and important time-varying confounders, we analyze the Polish Panel Survey which has been collecting data on participants' social mobility perceptions along with information on their self-reported physical health and psychological wellbeing.

RESULTS

We find that perceived social mobility is a significant predictor of self-reported physical health and psychological wellbeing, even in models that adjust for a host of theoretically relevant control variables. The results demonstrate that upward subjective mobility has a consistent and strong positive effect on health outcomes. The effect of perceived social mobility is stronger for males and for those with less advantageous social origins.

CONCLUSIONS

Our findings are in line with the "from rags to riches" theoretical perspective, emphasizing the positive implications of upward social mobility on health through various psychological mechanisms. Based on our findings, we call for greater scholarly attention to subjective aspects of social mobility in research on health outcomes.

Financial strain moderates genetic influences on self-rated health: support for diathesis-stress model of gene-environment interplay

Data from the Interplay of Genes and Environment across Multiple Studies (IGEMS) consortium were used to examine predictions of different models of gene-by-environment interaction to understand how genetic variance in self-rated health (SRH) varies at different levels of financial strain. A total of 11,359 individuals from 10 twin studies in Australia, Sweden, and the United States contributed relevant data, including 2,074 monozygotic and 2,623 dizygotic twin pairs. Age ranged from 22 to 98 years, with a mean age of 61.05 (SD = 13.24). A factor model was used to create a harmonized measure of financial strain across studies and items. Twin analyses of genetic and environmental variance for SRH incorporating age, age², sex, and financial strain moderators indicated significant financial strain moderation of genetic influences on self-rated health. Moderation results did not differ across sex or country. Genetic variance for SRH increased as financial strain increased, matching the predictions of the diathesis-stress and social comparison models for components of variance. Under these models, environmental improvements would be expected to reduce genetically based health disparities.

Subjective social status is associated with happiness but not weight status or psychological distress: An analysis of three prospective birth cohorts from low- and middle-income countries

BACKGROUND

Subjective social status (SSS, perception of social position relative to a frame of reference) has been associated with physical, mental and socio-emotional wellbeing. However, these associations may be susceptible to unmeasured confounding by life course objective socio-economic position (SEP; such as wealth, education and employment) and life satisfaction.

PURPOSE

To estimate the association of position on ladders of perceived community respect and perceived economic status with weight, distress and wellbeing, independent of objective SEP in cohorts from three low and middle-income countries.

METHODS

We used data from birth cohorts in Guatemala (n = 1258), Philippines (n = 1323) and South Africa (n = 1393). We estimated the association of perceived community respect and perceived economic status with body mass index (kg/m²), the World Health Organization's Self-Reported Questionnaire-20 (SRQ-20) for psychological distress, and Lyubomirsky's Subjective Happiness Scale. We estimated these associations using robust linear regression models adjusting for indicators of life course objective SEP, early life characteristics, adult covariates, and life satisfaction.

RESULTS

Participants in South Africa (age 27-28y) rated themselves higher on average for both the respect (7 vs 5 in Guatemala and 6 in Philippines) and economic (5 vs 3 in Guatemala and 4 in Philippines) ladder measures. Position on neither community respect nor economic ladders were associated with BMI or psychological distress. Higher position on community respect (Guatemala: 0.03, 95%CI: 0.01, 0.04; Philippines: 0.03, 95% CI: 0.02, 0.05; South Africa: 0.07, 95%CI: 0.04, 0.09) and economic (Guatemala: 0.02, 95%CI: 0, 0.04; Philippines: 0.04, 95%CI: 0.02, 0.07; South Africa: 0.07, 95%CI: 0.04, 0.10) ladders were associated with greater happiness.

CONCLUSIONS

Subjective social status showed small but consistent associations with happiness in birth cohorts independent of life-course SEP.

Socioeconomic Status Association With Dependency From Objective and Subjective Assessments: A Cross-Sectional Study

BACKGROUND

The effect of socioeconomic status (SES) on dependency is still complex and not fully clear. The purposes of this study are to assess the association between SES and dependency personality disorder (DPD) using both objective and subjective assessments.

METHODS

A cross-sectional study was conducted in 27 locations in China among 1,276 general residents aged 60 years and above through a complex multistage sampling design. Data were collected using a questionnaire by well-trained investigators through face-to-face interviews. The DPD was assessed using a standardized Chinese version of the Minnesota Multiphasic Personality Inventory-II scale. Objective SES was assessed by the combination of education levels, individual income, preretirement occupation, and medical insurance. Subjective SES was measured using the MacArthur Scale. The logistic regression analysis was used to evaluate the association between objective SES and DPD. Analysis of covariance was conducted to compare the mean of DPD scores in different levels of SES.

RESULTS

The results of the chi-squared test showed that the levels of objective SES were associated with DPD, depression, social resources, and region. The logistic regression analysis showed a significant negative association between the levels of objective SES and DPD. The odds ratio was 1.84 (95% confidence interval, 1.07-3.18) after adjusting for important confounding factors. The analysis of covariance showed differences in the mean of DPD scores among different groups defined by different levels of SES.

CONCLUSION

The levels of SES were negatively associated with DPD, and subjective SES had a stronger association with DPD than objective SES. The effect of subjective SES on DPD is possibly associated with the perception of position in the social hierarchy.