Seeing Class in Ladders: An Integrated Approach to Subjective Status and Health Inequality

Subjective social status, or one’s perceived rank within society, predicts individual health, often matching objective socioeconomic status (SES) indicators such as education or income in this capacity. While rank- or ladder-based measurement of subjective status is typical, subjective social class identification (e.g., seeing oneself as “working class” or “middle class”) remains a relatively neglected approach. Drawing on two recent national datasets and several measures of subjective status, I find that subjective class identification partly explains links between objective SES and subjective ladder scores. Adjusted distributions of ladder scores differ strikingly by subjective social class, with peaks and troughs highly dependent on class identity and ladder question wording. Crucially, subjective class and ladder systems both contribute to predicting self-rated health, net of each other and at similar, substantial levels. In sum, Americans significantly associate ladders with class. Thus, a sole emphasis on ladder-based approaches misses the categorical and cultural construction of subjective status, limiting our insight into health inequality.

Upward or downward comparison? Migrants’ socioeconomic status and subjective wellbeing in Chinese cities

Understanding the mechanism by which internal migrants evaluate their quality of life is essential for understanding the social integration of migrants into Chinese cities. A few studies have examined the linkages between internal migrants’ objective socioeconomic status and subjective wellbeing in the Chinese context, but they assume that migrants compare themselves with either their sending communities or receiving cities when evaluating their working and living conditions. This paper examines the effect of internal migrants’ objective socioeconomic status on subjective wellbeing in Chinese cities, with a particular focus on the mediating role of perceived living standards relative to multiple reference groups and the differences between first- and second-generation migrants. Multi-level structural equation models are used to analyse data from the 2014 China Labour-force Dynamic Survey. Results from baseline regressions indicate that migrants’ family income is positively associated with their subjective wellbeing in both a direct and an indirect manner, while homeownership in the host city is only related to it in an indirect way. The relationship between family income, homeownership in the host city and subjective wellbeing is significantly mediated by perceived living standards relative to the reference groups of schoolmates, neighbours and local urban residents in the destination city. Results from the comparison between two generations of migrants indicate that only family income is positively associated with the subjective wellbeing of first-generation migrants. By contrast, for second-generation migrants, homeownership in the destination city is indirectly related to subjective wellbeing through perceived living standards relative to local urban residents.

Socioeconomic Inequalities in Frailty in Hong Kong, China: A 14-Year Longitudinal Cohort Study

The prevalence of frailty varies among socioeconomic groups. However, longitudinal data for the association between subjective social status and frailty is limited. In this study, we examined whether subjective social status was associated with incident frailty. Data were obtained from a 14-year cohort of Chinese men and women (n = 694) aged 65 years and older who participated in the MrOs study—a longitudinal study on osteoporosis and general health in Hong Kong. Subjective social status at baseline (2001–2003) was assessed using a 10-rung self-anchoring scale. Incident frailty at the 14-year follow-up (2015–2017) was defined as proposed by Fried and colleagues. Ordinal logistic regressions were used to examine the association between subjective social status (high, middle, or low) and incident frailty. After adjustment for age, sex, marital status, objective socioeconomic status, medical history, lifestyle, mental health, and cognitive function, subjective social status at baseline was negatively associated with risk of developing frailty over time (OR 2.3, 95% CI 1.2–4.6). In sex-stratified analysis, the social gradient in frailty was only found in men. Social inequality in frailty in men but not in women supports interventions specific to gender inequality and frailty.

Socioeconomic disparities in psychological health: Testing the Reserve Capacity Model in a population-based sample of Chinese migrants

Based on the Reserve Capacity Model, this study investigated the associations of objective socioeconomic status and subjective social status with psychological health and the underlying psychosocial mechanisms in a population-based sample of Chinese migrants ( n = 15,999). Results showed that subjective social status was positively associated with life satisfaction and self-rated health through the mediation of psychological distress and perceived stress. Whereas education showed a very weak association with life satisfaction, income was directly associated with life satisfaction only. The findings suggest that reducing psychosocial vulnerabilities may be a potential impetus to eliminate socioeconomic health disparities among Chinese migrants.

Subjective social status and health: Multidisciplinary explanations and methodological challenges

Since the early 2000s, evidence has been accumulating that subjective social status – a person’s sense of their own position on the social ladder – affects health above and beyond objective socioeconomic status. To date, however, little is known about how these distinct health effects of subjective social status can be explained. This article narratively reviews different explanatory approaches and key methodological challenges, backed up by empirical findings and supplemented by the authors’ own reflections. Both social–psychological and psychoneurobiological explanations can make a theoretically plausible contribution to explaining the subjective social status–health relationship. Experimental and panel designs appear promising for addressing important methodological challenges in this strand of research.

One size does not fit all: Links between shift-and-persist and asthma in youth are moderated by perceived social status and experience of unfair treatment

The links between low socioeconomic status and poor health are well established, yet despite adversity, some individuals with low socioeconomic status appear to avoid these negative consequences through adaptive coping. Previous research found a set of strategies, called shift-and-persist (shifting the self to stressors while persisting by finding meaning), to be particularly adaptive for individuals with low socioeconomic status, who typically face more uncontrollable stressors. This study tested (a) whether perceived social status, similar to objective socioeconomic status, would moderate the link between shift-and-persist and health, and (b) whether a specific uncontrollable stressor, unfair treatment, would similarly moderate the health correlates of shift-and-persist. A sample of 308 youth (Meanage= 13.0, range 8–17), physician diagnosed with asthma, completed measures of shift-and-persist, unfair treatment, asthma control, and quality of life in the lab, and 2 weeks of daily diaries about their asthma symptoms. Parents reported on perceived family social status. Results indicated that shift-and-persist was associated with better asthma profiles, only among youth from families with lower (vs. higher) parent-reported perceived social status. Shift-and-persist was also associated with better asthma profiles, only among youth who experienced more (vs. less) unfair treatment. These findings suggest that the adaptive values of coping strategies for youth with asthma depend on the family's perceived social status and on the stressor experienced.

Subjective Social Status and Adolescent Health

Despite adolescence being a period marked by significant social changes, research on social status focuses largely on adults. This study examined whether school and societal subjective social status (SSS) are differentially associated with adolescent health above and beyond objective socioeconomic status (SES), and explored pathways linking SSS to health. Latino ( n = 169) and Asian American ( n = 77) adolescents ( M age = 17.23, SD = 0.74; 59% female) completed self-reports of SSS, sleep, stress, and somatic symptoms. Parents reported income and education. Blood pressure (BP) measurements were obtained. Results indicate that independent of objective SES, lower school SSS was associated with higher diastolic BP whereas lower societal SSS was associated with more somatic symptoms. Sleep disruptions and perceived stress mediated the association between societal SSS and somatic symptoms. Results suggest that SSS may be more important to adolescent health than objective SES. Furthermore, school and societal SSS may differentially affect indicators of health through different pathways.