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Compared to whom? Subjective social status, self-rated health, and referent group sensitivity in a diverse US sample

Listed author(s):
  • Wolff, Lisa S.
  • Subramanian, S.V.
  • Acevedo-Garcia, Dolores
  • Weber, Deanne
  • Kawachi, Ichiro
Registered author(s):

    Emerging research has revealed that subjective social status (SSS), or how people perceive their position in the social hierarchy, is significantly associated with multiple health outcomes. Yet few studies have examined how this association is affected by the person or group to whom respondents are comparing themselves. While previous studies have used distal referent groups when assessing SSS, scholars have suggested that individuals may prefer to make comparisons to those who share similar characteristics to themselves. Overall, there has been little empirical analysis assessing the health impact of comparing oneself to one referent group over another. Using a diverse, national US sample (n = 3644), this study explores whether the relationship between SSS and self-rated health is sensitive to the referent used for social comparison. Data are from respondents who completed the ConsumerStyles and HealthStyles mail surveys and who have assessed their SSS against four referents: others in American society, others of the same race or ethnicity, neighbors, and parents at the same age. Self-rated health was the dependent variable, while we controlled for household income, education, home ownership, race/ethnicity, and other covariates. In logistic regression models, SSS using each of the four referents was significantly associated with self-rated health, but the model using the referent of others in American society had the strongest association with self-rated health and was the most parsimonious. Findings validate previous studies which typically have used a more distal referent such as others in American society in exploring the SSS-health relationship. However, future work should explore whether this referent is salient to diverse population groups when making social comparisons. Researchers may also want to consider using SSS as an additional status measure since it may capture more subtle differences in the status hierarchy than traditional economic measures.

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    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 70 (2010)
    Issue (Month): 12 (June)
    Pages: 2019-2028

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    Handle: RePEc:eee:socmed:v:70:y:2010:i:12:p:2019-2028
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    1. 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.
    2. Oakes, J. Michael & Rossi, Peter H., 2003. "The measurement of SES in health research: current practice and steps toward a new approach," Social Science & Medicine, Elsevier, vol. 56(4), pages 769-784, February.
    3. Singh-Manoux, Archana & Adler, Nancy E. & Marmot, Michael G., 2003. "Subjective social status: its determinants and its association with measures of ill-health in the Whitehall II study," Social Science & Medicine, Elsevier, vol. 56(6), pages 1321-1333, March.
    4. Siahpush, Mohammad & Borland, Ron & Taylor, Janet & Singh, Gopal K. & Ansari, Zahid & Serraglio, Adrian, 2006. "The association of smoking with perception of income inequality, relative material well-being, and social capital," Social Science & Medicine, Elsevier, vol. 63(11), pages 2801-2812, December.
    5. Franzini, Luisa & Fernandez-Esquer, Maria Eugenia, 2006. "The association of subjective social status and health in low-income Mexican-origin individuals in Texas," Social Science & Medicine, Elsevier, vol. 63(3), pages 788-804, August.
    6. Macleod, John & Davey Smith, George & Metcalfe, Chris & Hart, Carole, 2005. "Is subjective social status a more important determinant of health than objective social status? Evidence from a prospective observational study of Scottish men," Social Science & Medicine, Elsevier, vol. 61(9), pages 1916-1929, November.
    7. Bzostek, Sharon & Goldman, Noreen & Pebley, Anne, 2007. "Why do Hispanics in the USA report poor health?," Social Science & Medicine, Elsevier, vol. 65(5), pages 990-1003, September.
    8. Dunn, James R. & Veenstra, Gerry & Ross, Nancy, 2006. "Psychosocial and neo-material dimensions of SES and health revisited: Predictors of self-rated health in a Canadian national survey," Social Science & Medicine, Elsevier, vol. 62(6), pages 1465-1473, March.
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