title: Psychological resources as mediators of the association between social class and health: comparative findings from Japan and the USA.
abstract: BACKGROUND
  Recently, researchers have proposed that psychological resources might be key concept in explaining the association between social class and health. However, empirical examinations of the extent to which psychological resources to social class in health are still few.
  
  
  OBJECTIVE
  This study investigated mediating effects of selected psychological resources (sense of control, self-esteem, optimism, and neuroticism) on the association of social class [education and subjective social status (SSS)] with current health status (self-rated health and the number of chronic conditions).
  
  
  METHODS
  This sample consisted of 1,805 Americans (818 males and 987 females) from the Midlife in the United States (MIDUS) survey, 2004-2006 and 1,027 Japanese (505 males and 522 females) from the Midlife in Japan (MIDJA) survey in Tokyo, Japan, 2008-2010. Information on social class, psychological resources, and health status was obtained using telephone interviews or written questionnaires.
  
  
  RESULTS
  A mediation analysis was conducted separately for males and females in Japan and the USA. Neuroticism significantly mediated the association of education and SSS with self-rated health and chronic conditions among males and females in both countries, with one exception (not for chronic conditions among Japanese females). Sense of control significantly mediated the association of education and SSS with self-rated health among males and females in both countries. As hypothesized, self-esteem significantly mediated almost all of the associations of education and SSS with self-rated health and chronic conditions among men and women in the USA, but very few such associations in Japan. Optimism significantly mediated most associations of social class and health status in both countries, but only among females.
  
  
  CONCLUSIONS
  Overall, the findings underscore important culture- and gender specificity in the ways in which psychosocial resources mediate the links between social class and health.
authors.affiliation: The University of Tokyo, Tokyo, Japan, c-kan@umin.ac.jp.
authors.forename: Chiemi
authors.initials: C
authors.lastname: Kan
authors.forename: Norito
authors.initials: N
authors.lastname: Kawakami
authors.forename: Mayumi
authors.initials: M
authors.lastname: Karasawa
authors.forename: Gayle Dienberg
authors.initials: GD
authors.lastname: Love
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Coe
authors.forename: Yuri
authors.initials: Y
authors.lastname: Miyamoto
authors.forename: Carol D
authors.initials: CD
authors.lastname: Ryff
authors.forename: Shinobu
authors.initials: S
authors.lastname: Kitayama
authors.forename: Katherine B
authors.initials: KB
authors.lastname: Curhan
authors.forename: Hazel Rose
authors.initials: HR
authors.lastname: Markus
mesh_terms: D000328:Adult; D000339:Affect; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000523:psychology*; D002908:Chronic Disease; D004522:Educational Status; D005260:Female; D006304:Health Status; D006801:Humans; D007389:Internal-External Control; D007564:Japan; D008297:Male; D008875:Middle Aged; D000075384:Neuroticism; D012649:Self Concept; D057566:Self Report; D012737:Sex Factors; D012923:Social Class; D011795:Surveys and Questionnaires; D014481:United States