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Social status and health: A comparison of British civil servants in Whitehall-II with European- and African-Americans in CARDIA

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  • Adler, Nancy
  • Singh-Manoux, Archana
  • Schwartz, Joseph
  • Stewart, Judith
  • Matthews, Karen
  • Marmot, Michael G.

Abstract

Socioeconomic status (SES) is related to health in every industrialized society where it has been studied. Indicators include educational attainment, occupational status, and income. Subjective social status (SSS), a summative judgment of one's socioeconomic position across these dimensions, also appears to be associated with health status. The current study examines whether SSS has similar associations with SES indicators and with health outcomes among British civil servants (participants in the Whitehall-II study), and U.S. whites and blacks (participants in the CARDIA study). The comparisons shed light on social status in the U.S. and England and on the applicability of findings from Whitehall-II to both whites and blacks in the U.S. Parallel analyses in each group examined (1) the extent to which income, education, and occupational status determine SSS ratings, (2) the association of SSS with hypertension, depression, and global health, and (3) the extent to which adjustment for education, occupation and income individually and collectively reduce the association of SSS and health outcomes. As predicted, occupation is a more important determinant of SSS in Whitehall-II than in CARDIA; adjustment for occupation reduces the association between SSS and health outcomes more for the Whitehall-II participants--especially males--than for CARDIA participants. Among the latter, education and income play relatively greater roles. Socioeconomic factors do not predict SSS scores for blacks as well as they do for the other two groups. SSS is significantly related to global health and depression in all groups and to hypertension in all groups except black males. Overall, relationships of SSS and health were stronger for Whitehall-II and white CARDIA participants than for blacks in CARDIA.

Suggested Citation

  • Adler, Nancy & Singh-Manoux, Archana & Schwartz, Joseph & Stewart, Judith & Matthews, Karen & Marmot, Michael G., 2008. "Social status and health: A comparison of British civil servants in Whitehall-II with European- and African-Americans in CARDIA," Social Science & Medicine, Elsevier, vol. 66(5), pages 1034-1045, March.
    • Handle: RePEc:eee:socmed:v:66:y:2008:i:5:p:1034-1045
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    2. Wolff, Lisa S. & Subramanian, S.V. & Acevedo-Garcia, Dolores & Weber, Deanne & Kawachi, Ichiro, 2010. "Compared to whom? Subjective social status, self-rated health, and referent group sensitivity in a diverse US sample," Social Science & Medicine, Elsevier, vol. 70(12), pages 2019-2028, June.
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    12. Sakurai, Keiko & Kawakami, Norito & Yamaoka, Kazue & Ishikawa, Hirono & Hashimoto, Hideki, 2010. "The impact of subjective and objective social status on psychological distress among men and women in Japan," Social Science & Medicine, Elsevier, vol. 70(11), pages 1832-1839, June.
    13. Zachary Zimmer & Heidi Hanson & Ken Smith, 2016. "Childhood socioeconomic status, adult socioeconomic status, and old-age health trajectories," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 34(10), pages 285-320.
    14. Lee, Miaw-Chwen & Huang, Nicole, 2015. "Changes in self-perceived economic satisfaction and mortality at old ages: Evidence from a survey of middle-aged and elderly adults in Taiwan," Social Science & Medicine, Elsevier, vol. 130(C), pages 1-8.
    15. Landefeld, John C. & Burmaster, Katharine B. & Rehkopf, David H. & Syme, S. Leonard & Lahiff, Maureen & Adler-Milstein, Sarah & Fernald, Lia C.H., 2014. "The association between a living wage and subjective social status and self-rated health: A quasi-experimental study in the Dominican Republic," Social Science & Medicine, Elsevier, vol. 121(C), pages 91-97.
    16. Hong Zou & Qianqian Xiong & Hongwei Xu, 2020. "Does Subjective Social Status Predict Self-Rated Health in Chinese Adults and Why?," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 152(2), pages 443-471, November.
    17. Jens Hoebel & Ulrike E Maske & Hajo Zeeb & Thomas Lampert, 2017. "Social Inequalities and Depressive Symptoms in Adults: The Role of Objective and Subjective Socioeconomic Status," PLOS ONE, Public Library of Science, vol. 12(1), pages 1-18, January.
    18. Mujahid, Mahasin S. & James, Sherman A. & Kaplan, George A. & Salonen, Jukka T., 2017. "Socioeconomic position, John Henryism, and incidence of acute myocardial infarction in Finnish men," Social Science & Medicine, Elsevier, vol. 173(C), pages 54-62.
    19. Reitzel, Lorraine R. & Mazas, Carlos A. & Cofta-Woerpel, Ludmila & Vidrine, Jennifer I. & Businelle, Michael S. & Kendzor, Darla E. & Li, Yisheng & Cao, Yumei & Wetter, David W., 2010. "Acculturative and neighborhood influences on subjective social status among Spanish-speaking Latino immigrant smokers," Social Science & Medicine, Elsevier, vol. 70(5), pages 677-683, March.
    20. Zachary Zimmer & Heidi A. Hanson & Ken R. Smith, 2016. "Offspring Socioeconomic Status and Parent Mortality Within a Historical Population," Demography, Springer;Population Association of America (PAA), vol. 53(5), pages 1583-1603, October.
    21. Kim, Jae-Hyun & Lee, Sang Gyu & Shin, Jaeyong & Park, Eun-Cheol, 2014. "Impact of the gap between socioeconomic stratum and subjective social class on depressive symptoms: Unique insights from a longitudinal analysis," Social Science & Medicine, Elsevier, vol. 120(C), pages 49-56.

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