Compared to whom? Subjective social status, self-rated health, and referent group sensitivity in a diverse US sample.
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.
Wolff
Lisa S
LS
Health Resources in Action, Research and Evaluation Department, Boston, MA, United States. Electronic address: lwolff@hria.org.
Subramanian
S V
SV
Harvard School of Public Health, Department of Society, Human Development, and Health, Boston, MA, United States.
Acevedo-Garcia
Dolores
D
Northeastern University, Bouvé College of Health Sciences, Boston, MA, United States.
Weber
Deanne
D
Porter Novelli, Strategic Planning and Research, Washington, DC, United States.
Kawachi
Ichiro
I
Harvard School of Public Health, Department of Society, Human Development, and Health, Boston, MA, United States.
D003625:Data Collection; D005260:Female; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012649:Self Concept; D012923:Social Class; D012938:Social Perception; D012959:Socioeconomic Factors; D014481:United States
BMJ. 1998 Oct 3;317(7163):917-21
9756809
Med Care. 1994 Sep;32(9):930-42
8090045
Am J Epidemiol. 1999 Jan 1;149(1):41-6
9883792
Health Psychol. 2000 Nov;19(6):586-92
11129362
Int J Epidemiol. 2002 Dec;31(6):1192-9; discussion 1199-200
12540721
Psychosom Med. 2005 Nov-Dec;67(6):855-61
16314589
Annu Rev Public Health. 1997;18:341-78
9143723
Health Psychol. 2000 Nov;19(6):613-8
11129365
Soc Sci Med. 2008 Mar;66(5):1034-45
18180089
Eur J Soc Psychol. 2006 Sep;36(5):747-760
17330149
J Gerontol B Psychol Sci Soc Sci. 1998 May;53(3):S144-52
9602839
Nicotine Tob Res. 2007 May;9(5):571-80
17454713
Soc Sci Med. 2006 Mar;62(6):1465-73
16154675
Pers Soc Psychol Bull. 2005 Apr;31(4):467-82
15743982
Soc Sci Med. 2006 Dec;63(11):2801-12
16971030
Ethn Health. 1996 Sep;1(3):293-303
9395574
J Immigr Minor Health. 2008 Jun;10(3):229-38
17653864
Ethn Health. 2008 Sep;13(4):289-303
18701990
J Health Soc Behav. 1997 Mar;38(1):21-37
9097506
Public Health. 2006 Jun;120(6):543-50
16684550
Ann N Y Acad Sci. 1999;896:48-63
10681887
Ann N Y Acad Sci. 1999;896:131-44
10681894
BMJ. 1997 Feb 22;314(7080):591-5
9055723
Soc Sci Med. 2005 Nov;61(9):1916-29
15916842
Soc Sci Med. 2003 Feb;56(4):769-84
12560010
Am J Epidemiol. 2002 Apr 15;155(8):755-9
11943694
J Epidemiol Community Health. 2006 Apr;60(4):364-72
16537356
J Gen Intern Med. 2006 Mar;21(3):267-75
16336622
Soc Sci Med. 2006 Aug;63(3):788-804
16580107
J Am Geriatr Soc. 2005 Mar;53(3):483-8
15743294
Soc Sci Med. 2007 Sep;65(5):990-1003
17574713
J Health Commun. 2010 Mar;15(2):167-88
20390985
J Epidemiol Community Health. 2005 Aug;59(8):664-9
16020643
Am J Prev Med. 2007 Sep;33(3):250-64
17826585
Soc Sci Med. 2003 Mar;56(6):1321-33
12600368