Top

International Journal of Behavioral Medicine

Published in:

01-06-2014

Association of Subjective and Objective Socioeconomic Status with Subjective Mental Health and Mental Disorders Among Japanese Men and Women

Authors: Kaori Honjo, Norito Kawakami, Masao Tsuchiya, Keiko Sakurai, WMH-J 2002–2006 Survey Group

Published in: International Journal of Behavioral Medicine | Issue 3/2014

Abstract

Background

An inverse association between socioeconomic status (SES) and mental health has been previously well reported, but the evidence is limited in Asian populations.

Purpose

We therefore investigated the association of SES and subjective mental health and prevalence of any mental disorders in the general population of Japan.

Method

We used data from the World Mental Health Japan Survey of 1,496 randomly selected people aged 20 years and older in Japan. Information on education level and household income were used as objective SES indicators, and subjective social status (SSS) was measured by responses to a question regarding social position. We calculated odds ratios of SES indicators for poor subjective mental health and 12-month prevalence of any mental disorders.

Results

The adjusted odds ratio (OR) (95 % confidence interval (CI)) of respondents who rated themselves as lower than middle status in the country (low SSS group) for poor subjective mental health was 2.24 (95 % CI: 1.41, 3.57) with reference to those who rated themselves as higher than middle status (high SSS group). Similarly, inverse associations of education level and household income with poor subjective mental health were identified. A J-shaped association was confirmed between SSS and 12-month prevalence of any mental disorders. The adjusted OR (95 % CI) of SSS for any mental diseases was 0.53 (95 % CI: 0.32, 0.86) for the middle SSS group and 1.61 (95 % CI: 0.96, 2.72) for the low SSS group, compared with the high SSS group. Those associations were not attenuated when objective SES indicators were adjusted.

Conclusion

We found inversely linear associations between subjective and objective SES and poor subjective mental health among Japanese men and women. SSS was not significantly associated with 12-month prevalence of any mental disorders. Substantial social inequalities in mental health were identified in Japan, which has been considered an egalitarian society with relatively few inequalities in health.

Lorant V, Deliege D, Eaton W, Robert A, Philippot P, Ansseau M. Socioeconomic inequalities in depression: a meta-analysis. Am J Epidemiol. 2003;157(2):98–112.PubMedCrossRef

Bromet E, Andrade LH, Hwang I, Sampson NA, Alonso J, de Girolamo G, et al. Cross-national epidemiology of DSM-IV major depressive episode. BMC Med. 2011;9:90. doi:10.1186/1741-7015-9-90.PubMedCentralPubMedCrossRef

Merikangas KR, Low NC. The epidemiology of mood disorders. Curr Psychiatry Rep. 2004;6(6):411–21.PubMedCrossRef

Lynch J, Kaplan G. Socioeconomic position. In: Berkman LF, Kawachi I, editors. Social epidemiology. New York: Oxford university press; 2000. p. 13–35.

Fryers T, Melzer D, Jenkins R. Social inequalities and the common mental disorders: a systematic review of the evidence. Soc Psychiatry Psychiatr Epidemiol. 2003;38(5):229–37. doi:10.1007/s00127-003-0627-2.PubMedCrossRef

Collins AL, Goldman N. Perceived social position and health in older adults in Taiwan. Soc Sci Med. 2008;66(3):536–44. doi:10.1016/j.socscimed.2007. 10.004.PubMedCentralPubMedCrossRef

Singh-Manoux A, Adler NE, Marmot MG. Subjective social status: its determinants and its association with measures of ill-health in the Whitehall II study. Soc Sci Med. 2003;56(6):1321–33.PubMedCrossRef

Singh-Manoux A, Marmot MG, Adler NE. Does subjective social status predict health and change in health status better than objective status? Psychosom Med. 2005;67(6):855–61. doi:10.1097/01.psy.0000188434.52941.a0.PubMedCrossRef

Kamran S, Bener AB, Deleu D, Khoja W, Jumma M, Al Shubali A, et al. The level of awareness of stroke risk factors and symptoms in the gulf cooperation council countries: gulf cooperation council stroke awareness study. Neuroepidemiology. 2008;29(3–4):235–42. doi:10.1159/000112856.

10.

Adler NE, Epel ES, Castellazzo G, Ickovics JR. Relationship of subjective and objective social status with psychological and physiological functioning: preliminary data in healthy white women. Health Psychol. 2000;19(6):586–92.PubMedCrossRef

11.

Ostrove JM, Adler NE, Kuppermann M, Washington AE. Objective and subjective assessments of socioeconomic status and their relationship to self-rated health in an ethnically diverse sample of pregnant women. Health Psychol. 2000;19(6):613–8.PubMedCrossRef

12.

Demakakos P, Nazroo J, Breeze E, Marmot M. Socioeconomic status and health: the role of subjective social status. Soc Sci Med. 2008;67(2):330–40. doi:10.1016/j.socscimed.2008.03.038.PubMedCrossRef

13.

Honjo K, Kawakami N, Takeshima T, Tachimori H, Ono Y, Uda H, et al. Social class inequalities in self-rated health and their gender and age group differences in Japan. J Epidemiol. 2006;16(6):223–32.PubMedCrossRef

14.

Murata C, Kondo K, Hirai H, Ichida Y, Ojima T. Association between depression and socio-economic status among community-dwelling elderly in Japan: the Aichi Gerontological Evaluation Study (AGES). Health Place. 2008;14(3):406–14. doi:10.1016/j.healthplace.2007.08.007.PubMedCrossRef

15.

Andrade L, Caraveo-Anduaga JJ, Berglund P, Bijl RV, De Graaf R, Vollebergh W, et al. The epidemiology of major depressive episodes: results from the International Consortium of Psychiatric Epidemiology (ICPE) Surveys. Int J Methods Psychiatr Res. 2003;12(1):3–21.PubMedCrossRef

16.

Kawakami N, Takeshima T, Ono Y, Uda H, Hata Y, Nakane Y, et al. Twelve-month prevalence, severity, and treatment of common mental disorders in communities in Japan: preliminary finding from the World Mental Health Japan Survey 2002–2003. Psychiatry Clin Neurosci. 2005;59(4):441–52. doi:10.1111/j.1440-1819.2005.01397.x.PubMedCrossRef

17.

Jackman MR, Jackman RW. An interpretation of the relation between objective and subjective social status. Am Sociol Rev. 1973;38(5):569–82.PubMedCrossRef

18.

Adler N, Singh-Manoux A, Schwartz J, Stewart J, Matthews K, Marmot MG. Social status and health: a comparison of British civil servants in Whitehall-II with European- and African-Americans in CARDIA. Soc Sci Med. 2008;66(5):1034–45. doi:10.1016/j.socscimed.2007.11.031.PubMedCrossRef

19.

Wilkinson R. Unhealthy societies the afflictions of inequality. London: Rougtledge; 1996.CrossRef

20.

Sakurai K, Kawakami N, Yamaoka K, Ishikawa H, Hashimoto H. The impact of subjective and objective social status on psychological distress among men and women in Japan. Soc Sci Med. 2010;70(11):1832–9. doi:10.1016/j.socscimed.2010.01.019.PubMedCrossRef

21.

Kessler RC, Ustun TB. The World Mental Health (WMH) survey initiative version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). Int J Methods Psychiatr Res. 2004;13(2):93–121.PubMedCrossRef

22.

Demyttenaere K, Bruffaerts R, Posada-Villa J, Gasquet I, Kovess V, Lepine JP, et al. Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. JAMA. 2004;291(21):2581–90. doi:10.1001/jama.291.21.2581291/21/2581.PubMedCrossRef

23.

Atkinson ARL, Smeeding M. Income distribution in OECD countries. Evidence from Luxembourg income study. Paris: Organization for Economic Cooperation and Development; 1995.

24.

Shibuya K, Hashimoto H, Yano E. Individual income, income distribution, and self rated health in Japan: cross sectional analysis of nationally representative sample. BMJ. 2002;324(7328):16–9.PubMedCentralPubMedCrossRef

25.

Wolter K. Introduction to variance estimation. Berlin: Springer-Verlag; 1985.

26.

Ishida H. Health and social inequalities. In: Shirahase S, editor. Inequalities in a changing society: hidden disparities behind the demographic shift in Japan. Tokyo: University of Tokyo Press; 2006.

27.

Baum A, Garofalo JP, Yali AM. Socioeconomic status and chronic stress. Does stress account for SES effects on health? Ann N Y Acad Sci. 1999;896:131–44.PubMedCrossRef

28.

Garbarski D. Perceived social position and health: is there a reciprocal relationship? Soc Sci Med. 2010;70(5):692–9. doi:10.1016/j.socscimed.2009.11.007.PubMedCentralPubMedCrossRef

29.

Sato T. Tentaisuru Kaiso-ishiki. In: Sato Y, Ojima F, Ishida H, Kondo H, Nakao K, Saito Y, Misumi K, editors. Contemporary Stratified Society. Values and attitudes in a time of destabilization, vol 3. Tokyo: University of Tokyo Press; 2011. p. 3–14.

30.

Kawachi I, Fujisawa Y, Takao S. The health of Japanese- what can we learn from America? JNatil Inst Public Health. 2007;56(2):114–7.

31.

Tsutsumi A. Report of research project grant-in-aid for scientific research (C), 2007~2009 Epidemiological study on association between occupational class and health inequality: role of occupational stress 2010.

32.

Matthews KA, Gallo LC. Psychological perspectives on pathways linking socioeconomic status and physical health. Annu Rev Psychol. 2011;62:501–30. doi:10.1146/annurev.psych.031809.130711.PubMedCentralPubMedCrossRef

Title: Association of Subjective and Objective Socioeconomic Status with Subjective Mental Health and Mental Disorders Among Japanese Men and Women
Authors: Kaori Honjo
Norito Kawakami
Masao Tsuchiya
Keiko Sakurai
WMH-J 2002–2006 Survey Group
Publication date: 01-06-2014
Publisher: Springer US
Published in: International Journal of Behavioral Medicine / Issue 3/2014
Print ISSN: 1070-5503
Electronic ISSN: 1532-7558
DOI: https://doi.org/10.1007/s12529-013-9309-y

At a glance: The STEP trials

Springer Medicine

Association of Subjective and Objective Socioeconomic Status with Subjective Mental Health and Mental Disorders Among Japanese Men and Women

Abstract

Background

Purpose

Method

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Purpose

Method

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 3/2014

Spanish Version of the Children's Somatization Inventory: Factorial Structure and Psychometric Properties in a Community Sample

Depressive Symptoms are Associated with Lower Bone Mineral Density in Young Adults with High Job Strain. The Cardiovascular Risk in Young Finns Study

Type D Personality Is Associated with Social Anxiety in the General Population

Insomnia Symptoms, Depressive Symptoms, and Suicide Ideation in Japanese White-Collar Employees

The Role of Self-Monitoring and Response Inhibition in Improving Sleep Behaviours

An Age-Tailored Intervention Sustains Physical Activity Changes in Older Adults: A Randomized Controlled Trial