Subjective social status and its relationship to health and health behavior: comparing two different scales in university students

Self-rated health of university students in Germany-The importance of material, psychosocial, and behavioral factors and the parental socio-economic status

Introduction

Health inequalities start early in life. The time of young adulthood, between late teens and early twenties, is especially interesting in this regard. This time of emerging adulthood, the transition from being a child to becoming an adult, is characterized by the detachment from parents and establishing of an own independent life. From a health inequality perspective, the question about the importance of the socio-economic background of parents is important. University students are an especially interesting group. Many students come from a privileged background and the question of health inequality among university students has not yet been properly studied.

Methods

Based on the National Educational Panel Study (NEPS), we analyzed health inequalities among 9,000 students in Germany (∅ 20 years in the first year of their studies) over a period of 8 years.

Results

We found that most university students (92%) in Germany reported a good and very good health. Yet, we still found substantial health inequalities. Students whose parents had a higher occupational status reported less health problems. Additionally, we observed that health inequalities had indirect impact on health via health behavior, psychosocial resources, and material conditions.

Discussion

We believe our study is an important contribution to the understudied subject of students' health. We see the impact of social inequality on health among such a privileged group like university students as an important sign of the importance of health inequality.

Playing the complex game of social status in school - a qualitative study

BACKGROUND

Research suggests that social status in school plays an important role in the social lives of adolescents and that their social status is associated with their health. Additional knowledge about adolescents' understanding of social hierarchies could help to explain inequalities in adolescents' health and guide public health interventions.

OBJECTIVE

The study aimed to explore what contributes to subjective social status in school and the strategies used for social positioning.

METHODS

A qualitative research design with think-aloud interviews was used. The study included 57 adolescents in lower (7^th grade) and upper secondary school (12^th grade) in Sweden. Subjective social status was explored using a slightly modified version of the MacArthur Scale of Subjective Social Status in school. Data were analyzed using thematic network analysis.

RESULTS

The participants were highly aware of their social status in school. Elements tied to gender, age, ethnicity and parental economy influenced their preconditions in the positioning. In addition, expectations on how to look, act and interact, influenced the pursue for social desirability. The way these different factors intersected and had to be balanced suggests that social positioning in school is complex and multifaceted.

CONCLUSIONS

Because the norms that guided social positioning left little room for diversity, the possible negative impact of status hierarchies on adolescents' health needs to be considered. In school interventions, we suggest that norms on e.g. gender and ethnicity need to be addressed and problematized from an intersectional approach.

Relations between cannabis use, socioeconomic status, and risk perceptions in a Hispanic/Latinx population

Socioeconomic status (SES) and risk perceptions are indicative of cannabis use and subjective social status (SSS) may have utility in predicting cannabis use. This work examined relations between these indicators of cannabis use and use in a Hispanic/Latinx sample. Results found negative relations between risk perceptions and cannabis use. SES was unrelated to cannabis outcomes and risk perceptions but SSS had a negative relation with lifetime use. SSS positively related to risk assimilation in the full sample. Findings demonstrate how risk perceptions relate to cannabis use and suggest SES and SSS may not be indicative of use among Hispanic/Latinx populations.

[Social Inequalities in Health and Health Behaviors among University Students]

AIM OF THE STUDY

Disease prevention and health science research have focused increasingly on students in recent years. However, students are usually perceived as a homogeneous group. The aim of this article was to examine if there exist health inequalities among students.

METHODS

A nationwide student survey, the so-called NuPhA study, was used to answer this question (n=689, 69.5% female, average age: 22.69 years).

RESULTS AND CONCLUSIONS

We found that socio-economic indicators were associated with health and health behavior. For instance, being a scholarship holder was associated with a better general, mental, and physical health. In particular, subjective social status was positively associated with better general, mental, and physical health as well as higher physical activity. The results indicate that while students initially appeared to form a homogenous group, health inequalities exist among them. This suggests the need for a differentiated view on the student group and the importance of examining and explaining health inequalities among students in depth and to finally reduce them.

Self-rated health, subjective social status in school and socioeconomic status in adolescents: a cross-sectional study

BACKGROUND

Social position, traditionally measured by objective data on socioeconomic status (SES), is linked to health status in adults. In adolescents, the association is more uncertain and there are some studies suggesting that subjective social status (SSS) might be more adequate in relation to health. This study aimed to examine associations between SSS in school, SES and self-rated health (SRH) in adolescent boys and girls.

METHODS

A descriptive cross-sectional research design with quantitative survey data was used. The study involved 705 Swedish adolescents in upper secondary school (17-18-year-olds). SRH was measured with a single-item question and SSS by a question where adolescents were asked to assess their social position within their school. Formal education level of the parents was used as a proxy for objective SES. Univariable and multivariable ordinal regression analyses were conducted to assess the associations between SRH and SSS in school and SES.

RESULTS

In the multivariable analysis, SSS in school was positively associated with SRH, whereas no significant association between SES and SRH was found. The proportion of adolescents with high SRH increased with higher steps on the SSS ladder. Significant gender differences were found in that boys rated their SRH and SSS in school higher than girls did.

CONCLUSIONS

The study shows that self-rated health in adolescents is related to perceived social position in school. Subjective social status in school seems to be a useful health-related measure of social position in adolescents.