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Health Implications of Socioeconomic Characteristics, Subjective Social Status, and Perceptions of Inequality: An Empirical Study of China

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Abstract

This study explores how health is associated with socioeconomic status, subjective social status, and perceptions of inequality simultaneously. Two health outcomes (self-reported health and psychological distress) are examined, and the subtlety of their relationships with each of the three dimensions of inequality is probed. Data used come from a nationally representative sample survey conducted in China. Several findings emerge from empirical analyses: (1) Overall, the three dimensions of social inequality are associated with self-reported health and psychological distress net of each other and other control variables; (2) among focal socioeconomic characteristics, income and Chinese Communist Party membership are significantly associated with both health outcomes, education exhibits a robust effect on self-reported health, and rural and migrant statuses are linked to less distress; (3) subjective social status in comparisons with both socially proximal and broad referents is associated with both health outcomes, and the association with downward comparisons is more salient than with upward comparisons; and (4) perceived degree and perceived sources of inequality in society show varying relationships with the two health outcomes. These findings add to our understanding of the multidimensionality and complexity of social inequality in relation to health.

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Notes

  1. See Acknowledgements for the list of the American and Chinese social scientists participating in this wave of survey.

  2. As to be shown in the latter section, the weighted proportions of the three categories of perceived social status coded this way are .11, .52, and .37 respectively. Alternative coding of scores of 1–3, 4–7, and 8–10 into low, middle, and high perceived social status respectively was also attempted. The resulting proportions of the three categories are .03, .78, and .20 respectively with an overwhelming majority concentrating in the middle group and an excessively small proportion of people reporting high status. Regressions using the two different coding methods for this variable also show a better fit for the models using the coding method reported in the text.

  3. Alternative models without recoding the two types of subjective social status indicators into categorical variables were also run and have produced consistent results.

  4. The composite indexes for proximal comparison, individualistic attributions of inequality, and structural attributions of inequality computed with the method in this paper have been used in various studies involving perceptions of inequality and shown to be valid and reliable in a variety of societies including China (Han 2012a; Mason and Kluegel 2000; Whyte 2010a; Whyte and Han 2008). The high values of Cronbach’s alpha for the three composite indexes in this study further indicate their high level of reliability.

  5. Alternative models using the observations without missing information and ordinal logistic models for self-reported health were also run and have yielded similar results.

  6. As suggested by the anonymous reviewers, the interaction between gender and each inequality dimension as well as the interaction between unemployed status and each inequality measure are also investigated. Only the interaction between female and household income is significantly negative, indicating that self-reported health is more likely to be positively related to income among males than among females. None of the other interaction coefficients is statistically significant.

  7. The values of R2 in the four regressions for psychological distress range from .070 to .102. Larger values of R2 are desirable. Nevertheless, the four regressions are intended to explore whether and to what extent the socioeconomic characteristics, subjective social status, and perceptions of inequality under study are related to psychological distress. In this sense, the four models are sufficient.

  8. As suggested by the anonymous reviewers, the interaction between gender and each inequality dimension as well as the interaction between unemployed status and each inequality measure are also examined. Only the interaction between female and downward broad comparison and the interaction between female and individualistic attributions of inequality are significantly positive, showing that low perceived self status in society and explanations of inequality by individual factors are more likely to be related to great psychological distress among females than among males. None of the other interaction coefficients is statistically significant.

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Acknowledgments

The author is indebted to the second wave of the China Inequality and Distributive Justice Project conducted in 2009. Martin K. Whyte at Harvard University was the Principal Investigator for the project. The other investigators included Jieming Chen at Texas A&M University-Kingsville, Juan Chen at Hong Kong Polytechnic University, Chunping Han then a Ph.D. candidate at Harvard University, Pierre Landry then at Yale University, Albert Park at Oxford University, Mingming Shen at Peking University, Feng Wang at the University of California-Irvine, Jie Yan at Peking University, and Ming Yang at Peking University. Funding for the survey came from the Smith Richardson Foundation, Harvard China Fund, Yale University, Harvard Weatherhead Center for International Affairs, and Harvard Asia Center. The author would also like to thank the Social Indicators Research editor and anonymous reviewers for their helpful comments on an earlier version of this article.

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    Chunping Han

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Table 4 Bivariate correlations between dependent and independent variables (N = 2,866)
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Han, C. Health Implications of Socioeconomic Characteristics, Subjective Social Status, and Perceptions of Inequality: An Empirical Study of China. Soc Indic Res 119, 495–514 (2014). https://doi.org/10.1007/s11205-013-0514-5

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