title: The effect of subjective and objective social class on health-related quality of life: new paradigm using longitudinal analysis.
abstract: BACKGROUND
  To investigate the impact of the gap between subjective and objective social status on health-related quality of life.
  
  
  METHODS
  We analyzed data from 12,350 participants aged ≥ 18 years in the Korean Health Panel Survey. Health-related quality of life was measured by EuroQol-Visual analogue scale. Objective (income and education) and subjective social class (measured by MacArthur scale) was classified into three groups (High, Middle, Low). In terms of a gap between objective and subjective social class, social class was grouped into nine categories ranging from High-High to Low-Low. A linear mixed model was used to investigate the association between the combined social class and health-related quality of life.
  
  
  RESULTS
  The impact of the gap between objective and subjective status on Health-related quality of life varied according to the type of gap. Namely, at any given subjective social class, an individual's quality of life declined with a decrease in the objective social class. At any given objective social class (e.g., HH, HM, HL; in terms of both education and income), an individual's quality of life declined with a one-level decrease in subjective social class.
  
  
  CONCLUSIONS
  Our results suggest that studies of the relationship between social class and health outcomes may consider the multidimensional nature of social status.
authors.affiliation: Department of Public Health, Graduate School, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, South Korea. choiyoung223@yuhs.ac.|Institute of Health Services Research, College of Medicine, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, South Korea. choiyoung223@yuhs.ac.
authors.forename: Young
authors.initials: Y
authors.lastname: Choi
authors.affiliation: Department of Public Health, Graduate School, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, South Korea. kjh0930@yuhs.ac.|Institute of Health Services Research, College of Medicine, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, South Korea. kjh0930@yuhs.ac.
authors.forename: Jae-Hyun
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Preventive Medicine, College of Medicine, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, South Korea. ecpark@yuhs.ac.|Institute of Health Services Research, College of Medicine, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, South Korea. ecpark@yuhs.ac.
authors.forename: Eun-Cheol
authors.initials: EC
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D056910:Republic of Korea; D012923:Social Class; D012959:Socioeconomic Factors; D055815:Young Adult