Subjective social status: its determinants and its association with measures of ill-health in the Whitehall II study

Singh‐Manoux, Archana; Adler, Nancy E.; Marmot, Michael

doi:10.1016/s0277-9536(02)00131-4

Cited by 850 publications

(892 citation statements)

References 32 publications

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“…A priority for future research should be the longitudinal analysis of the associations examined here so that causality can be established. Secondly, although there is convincing evidence that SSS is not a product of psychological bias Hu et al, 2005;Operario et al, 2004;Singh-Manoux et al, 2003), future research could add to this line of research by testing the associations between SSS and health against potential confounders such as negative affectivity. Further, an examination of the role of gender in the associations of SSS with health outcomes is warranted given the gender differences this study has identified.…”

Section: Discussionmentioning

confidence: 99%

“…Also, there is evidence that SSS relates to adolescent health (Goodman, Adler, Daniels, Morrison, Slap, & Dolan, 2003;Goodman, Adler, Kawachi, Frazier, Huang, & Colditz, 2001). In contrast, research has shown that SSS is not related at all to body mass index, sleep quality, and resting systolic blood pressure in women , angina and respiratory illness in women (Singh-Manoux et al, 2003), and difficulties in Activities of Daily Living (Hu et al, 2005). Also, studies have shown that adjusting for objective indicators of SES attenuates the associations of SSS with perceptions of physical health (Franzini & Fernandez-Esquer, 2006), diabetes, self-rated health, and depression in both sexes, and angina and respiratory illness in men (Singh-Manoux et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

“…prestige) to make judgements about their own social status (Singh-Manoux, Adler, & Marmot, 2003) and identify to a variable extent with their objective socioeconomic situation, it is the objective indicators of SES that can be expected to constitute the basis of SSS. Current research, in line with these speculations, has suggested that SSS "reflects the cognitive averaging of standard markers of socioeconomic situation" (Singh-Manoux et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

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Socioeconomic status and health: The role of subjective social status

Demakakos

Nazroo

Breeze

et al. 2008

Social Science & Medicine

575

519

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Studies have suggested that subjective social status (SSS) is an important predictor of health. This study examined the link between SSS and health in old age and investigated whether SSS mediated the associations between objective indicators of socioeconomic status and health. It used crosssectional data from the second wave (2004-05) of the English Longitudinal Study of Ageing, which were collected through personal interviews and nurse visits. The study population consisted of 3368 men and 4065 women aged 52 years or older. The outcome measures included: self-rated health, long-standing illness, depression, hypertension, diabetes, central obesity, high-density lipoprotein cholesterol, triglycerides, fibrinogen, and C-reactive protein. The main independent variable was SSS measured using a scale representing a 10-rung ladder. Wealth, education, and occupational class were employed as covariates along with age and marital status and also, in additional analyses, as the main independent variables. Gender-specific logistic and linear regression analyses were performed. In age-adjusted analyses SSS was related positively to almost all health outcomes. Many of these relationships remained significant after adjustment for covariates. In men, SSS was significantly (p≤0.05) related to self-rated health, depression, and long-standing illness after adjustment for all covariates, while its association with fibrinogen became non-significant. In women, after adjusting for all covariates, SSS was significantly associated with self-rated health, depression, long-standing illness, diabetes, and high-density lipoprotein cholesterol, but its associations with central obesity and C-reactive protein became non-significant. Further analysis suggested that SSS mediated fully or partially the associations between education, occupational class and self-reported and clinical health measures. On the contrary, SSS did not mediate wealth's associations with the outcome measures, except those with self-reported health measures. Our results suggest that SSS is an important correlate of health in old age, possibly because of its ability to epitomize life-time achievement and socioeconomic status.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Socioeconomic status and health: The role of subjective social status

Demakakos

Nazroo

Breeze

et al. 2008

Social Science & Medicine

575

519

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“…Using validated standardized scales at baseline, we collected data on patient sociodemographic characteristics, SDH (including Medical Outcomes Study [MOS] survey 25 and subjective social status 26 30 ), and health care utilization. 22 …”

Section: Study Data and Outcome Measuresmentioning

confidence: 99%

Case Management may Reduce Emergency Department Frequent use in a Universal Health Coverage System: a Randomized Controlled Trial

et al. 2016

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BACKGROUND: Frequent emergency department (ED) users account for a disproportionately high number of ED visits. Studies on case management (CM) interventions to reduce frequent ED use have shown mixed results, and few studies have been conducted within a universal health coverage system. OBJECTIVE: To determine whether a CM intervention--compared to standard emergency care-reduces ED attendance. DESIGN: Randomized controlled trial. PARTICIPANTS: Two hundred fifty frequent ED users (5 or more visits in the prior 12 months) who visited a public urban ED at the Lausanne University Hospital between May 2012 and July 2013 were allocated to either an intervention (n = 125) or control (n = 125) group, and monitored for 12 months. INTERVENTIONS: An individualized CM intervention consisting of concrete assistance in obtaining income entitlements, referral to primary or specialty medical care, access to mental health care or substance abuse treatment, and counseling on at-risk behaviors and health care utilization (in addition to standard care) at baseline and 1, 3, and 5 months. MAIN MEASURES: We used a generalized linear model for count data (negative binomial distribution) to compare the number of ED visits during the 12-month follow-up between CM and usual care, from an intention-to-treat perspective.KEY RESULTS: At 12 months, there were 2.71 (±0.23) ED visits in the intervention group versus 3.35 (±0.32) visits among controls (ratio = 0.81, 95 % CI = 0.63; 1.02). In the multivariate model, the effect of the CM intervention on the number of ED visits approached statistical significance (b = −0.219, p = 0.075). The presence of poor social determinants of health was a significant predictor of ED use in the multivariate model (b = 0.280, p = 0.048). CONCLUSIONS: CM may reduce ED use by frequent users through an improved orientation to the health care system. Poor social determinants of health significantly increase use of the ED by frequent users.

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“…Subjective social status has been related to a range of health-related factors such as self-rated health, heart rate and body fat distribution (9) , and reflects the cognitive averaging of standard markers of socio-economic position rather than psychological biases (22) . Previous studies have established a link between SES and diet.…”

Section: Socio-economic Statusmentioning

confidence: 99%

Grocery purchasing among older adults by chewing ability, dietary knowledge and socio-economic status

Brennan

Singh

2010

Public Health Nutr.

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Objectives: Nutrition plays a central role in health, with poor dietary habits and nutritional intake being associated with a range of chronic diseases. The aim was to examine grocery purchasing behaviour in relation to chewing ability, dietary knowledge and socio-economic status (SES) among older adults. Design: Data were collected by mailed survey in 2008. Grocery purchasing was measured using a sixteen-item index of compliance of food purchasing with dietary guidelines. Self-reported number of teeth was classified as an inadequate dentition if less than twenty-one teeth were present. Chewing ability was based on a five-item chewing index. Dietary knowledge was collected using twenty true/false items. SES was assessed using a subjective social status rating representing where people stand in society. Setting: Population survey in Adelaide, South Australia. Subjects: Adults aged 60-71 years. Results: Responses were collected from 444 persons (response rate 5 68?8 %). Among dentate persons, 24?4 % had an inadequate dentition with 10?3 % defined as 'chewing deficient'. Multivariate regression coefficients adjusted for age, sex and income showed chewing deficiency (25?8) and low SES (23?6) was associated (P , 0?05) with lower grocery purchasing scores, but dietary knowledge was not statistically significant. Conclusions: For older adults, chewing deficiency and lower social status were associated with lower compliance with dietary guidelines, independent of dietary knowledge.

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Subjective social status: its determinants and its association with measures of ill-health in the Whitehall II study

Cited by 850 publications

References 32 publications

Socioeconomic status and health: The role of subjective social status

Socioeconomic status and health: The role of subjective social status

Case Management may Reduce Emergency Department Frequent use in a Universal Health Coverage System: a Randomized Controlled Trial

Grocery purchasing among older adults by chewing ability, dietary knowledge and socio-economic status

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