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Health and Quality of Life Outcomes
Published in: Health and Quality of Life Outcomes 1/2015

Open Access 01-12-2015 | Research

The effect of subjective and objective social class on health-related quality of life: new paradigm using longitudinal analysis

Authors: Young Choi, Jae-Hyun Kim, Eun-Cheol Park

Published in: Health and Quality of Life Outcomes | Issue 1/2015

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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.

Conclusion

Our results suggest that studies of the relationship between social class and health outcomes may consider the multidimensional nature of social status.
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Literature
1.
Adler NE, Rehkopf DH. US disparities in health: descriptions, causes, and mechanisms. Annu Rev Public Health. 2008;29:235–52.PubMedCrossRef
2.
Haan MN, Kaplan GA, Syme SL. Socioeconomic status and health: old observations and new thoughts. In: Bunker JP, Gomby DS, Kehrer BH, editors. Pathways to health: The role of social factors. Menlo Park, CA: The Henry J. Kaiser Family Foundation; 1989. p. 176–233.
3.
Marmot MG, Kogevinas M, Elston MA. Social/economic status and disease. Annu Rev Public Health. 1987;8:111–35.PubMedCrossRef
4.
Dalstra JA, Kunst AE, Borrell C, Breeze E, Cambois E, Costa G, et al. Socioeconomic differences in the prevalence of common chronic diseases: an overview of eight European countries. Int J Epidemiol. 2005;34(2):316–26.PubMedCrossRef
5.
Huisman M, Kunst AE, Bopp M, Borgan JK, Borrell C, Costa G, et al. Educational inequalities in cause-specific mortality in middle-aged and older men and women in eight western European populations. Lancet. 2005;365(9458):493–500.PubMedCrossRef
6.
Mackenbach JP, Kunst AE, Cavelaars AE, Groenhof F, Geurts JJ. Socioeconomic inequalities in morbidity and mortality in western Europe. Lancet. 1997;349(9066):1655–9.PubMedCrossRef
7.
Marmot MG, Bosma H, Hemingway H, Brunner E, Stansfeld S. Contribution of job control and other risk factors to social variations in coronary heart disease incidence. Lancet. 1997;350(9073):235–9.PubMedCrossRef
8.
Sobal J, Stunkard AJ. Socioeconomic status and obesity: a review of the literature. Psychol bull. 1989;105(2):260.PubMedCrossRef
9.
Jackman MR, Jackman RW. An interpretation of the relation between objective and subjective social status. Am Sociol Rev. 1973;38(5):569–82.PubMedCrossRef
10.
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
11.
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(5):855–61.PubMedCrossRef
12.
Cohen S, Alper CM, Doyle WJ, Adler N, Treanor JJ, Turner RB. Objective and subjective socioeconomic status and susceptibility to the common cold. Health Psychol. 2008;27(2):268.PubMedCrossRef
13.
Goodman E, Adler NE, Daniels SR, Morrison JA, Slap GB, Dolan LM. Impact of objective and subjective social status on obesity in a biracial cohort of adolescents. Obesity Research. 2003;11(8):1018–26.PubMedCrossRef
14.
15.
Franzini L, Fernandez-Esquer ME. The association of subjective social status and health in low-income Mexican-origin individuals in Texas. Soc Sci Med. 2006;63(3):788–804.PubMedCrossRef
16.
Leu J, Yen IH, Gansky SA, Walton E, Adler NE, Takeuchi DT. The association between subjective social status and mental health among Asian immigrants: Investigating the influence of age at immigration. Soc Sci Med. 2008;66(5):1152–64.PubMedCentralPubMedCrossRef
17.
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.PubMedCrossRef
18.
Wright CE, Steptoe A. Subjective socioeconomic position, gender and cortisol responses to waking in an elderly population. Psychoneuroendocrinology. 2005;30(6):582–90.PubMedCrossRef
19.
Kondo N, Kawachi I, Subramanian S, Takeda Y, Yamagata Z. Do social comparisons explain the association between income inequality and health?: Relative deprivation and perceived health among male and female Japanese individuals. Soc Sci Med. 2008;67(6):982–7.PubMedCentralPubMedCrossRef
20.
Von Rueden U, Gosch A, Rajmil L, Bisegger C, Ravens-Sieberer U. Socioeconomic determinants of health related quality of life in childhood and adolescence: results from a European study. J Epidemiol Community Health. 2006;60(2):130–5.CrossRef
21.
Goodman E, Huang B, Schafer-Kalkhoff T, Adler NE. Perceived socioeconomic status: a new type of identity that influences adolescents’ self-rated health. J Adolesc Health. 2007;41(5):479–87.PubMedCentralPubMedCrossRef
22.
Hu P, Adler NE, Goldman N, Weinstein M, Seeman TE. Relationship between subjective social status and measures of health in older Taiwanese persons. J Am Geriatr Soc. 2005;53(3):483–8.PubMedCrossRef
23.
Anderson NB, Armstead CA. Toward understanding the association of socioeconomic status and health: a new challenge for the biopsychosocial approach. Psychosom Med. 1995;57(3):213–25.PubMedCrossRef
24.
Winkleby MA, Jatulis DE, Frank E, Fortmann SP. Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease. Am J Public Health. 1992;82(6):816–20.PubMedCentralPubMedCrossRef
25.
Pappa E, Kontodimopoulos N, Papadopoulos AA, Niakas D. Assessing the socio-economic and demographic impact on health-related quality of life: evidence from Greece. Int J Public Health. 2009;54(4):241–9.PubMedCrossRef
26.
Testa MA, Simonson DC. Assessment of quality-of-life outcomes. N Eng J Med. 1996;334:835–40.CrossRef
27.
Bond J, Dickinson HO, Matthews F, Jagger C, Brayne C. Self-rated health status as a predictor of death, functional and cognitive impairment: a longitudinal cohort study. Eur J Ageing. 2006;3:193–206.CrossRef
28.
DeSalvo KB, Fan VS, McDonell MB, Fihn SD. Predicting mortality and healthcare utilization with a single question. Health Serv Res. 2005;40(4):1234–46.PubMedCentralPubMedCrossRef
29.
Rumsfeld JS, MaWhinney S, McCarthy Jr M, Shroyer ALW, VillaNueva CB, O'Brien M, et al. Health-related quality of life as a predictor of mortality following coronary artery bypass graft surgery. JAMA. 1999;281(14):1298–303.PubMedCrossRef
30.
Menec VH, Chipperfield JG, Perry RP. Self-perceptions of health: a prospective analysis of mortality, control, and health. J Gerontol B: Psychol Sci Soc Sci. 1999;54(2):85–93.CrossRef
31.
Kaplan GA, Camacho T. Perceived health and mortality: a nine-year follow-up of the human population laboratory cohort. Am J Epidemiol. 1983;117(3):292–304.PubMed
32.
Idler EL, Benyamini Y. Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav. 1997;21–37.
33.
Schwimmer JB, Burwinkle TM, Varni JW. Health-related quality of life of severely obese children and adolescents. JAMA. 2003;289(14):1813–9.PubMedCrossRef
34.
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.PubMedCrossRef
35.
Operario D, Adler NE, Williams DR. Subjective social status: reliability and predictive utility for global health. Psychol Health. 2004;19:237–46.CrossRef
36.
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.PubMedCrossRef
37.
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.PubMedCrossRef
38.
39.
Ware Jr JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Med Care. 1992;30(6):473–83.PubMedCrossRef
40.
Streiner DL, Norman GR, Cairney J. Health measurement scales: a practical guide to their development and use. Oxford University Press; 2014.
41.
Rabin R, Charro F. EQ-SD: a measure of health status from the EuroQol Group. Ann Med. 2001;33(5):337–43.PubMedCrossRef
42.
Cella DF, Bonomi AE, Lloyd SR, Tulsky DS, Kaplan E, Bonomi P. Reliability and validity of the Functional Assessment of Cancer Therapy—Lung (FACT-L) quality of life instrument. Lung Cancer. 1995;12(3):199–220.PubMedCrossRef
43.
Robert F, Paul M, John H. Measuring health status in arthritis, the arthritis impact measurement scale. Arthritis Rheum. 1980;23:146–52.CrossRef
44.
Kreuter M, Sullivan M, Dahllöf A, Siösteen A. Partner relationships, functioning, mood and global quality of life in persons with spinal cord injury and traumatic brain injury. Spinal Cord. 1998;36(4):252–61.PubMedCrossRef
45.
46.
Jin S, Kang H. The equivalence scale and poverty evaluation of the Korean urban households. The Korean Economic Association. 2006;54:61–97.
47.
48.
Pinheiro JC. Linear mixed effects models for longitudinal data. Encyclopedia of Biostatistics; 2005.
49.
Thumboo J, Fong K-Y, Machin D, Chan S-P, Soh C-H, Leong K-H, et al. Quality of life in an urban Asian population: the impact of ethnicity and socio-economic status. Soc Sci Med. 2003;56(8):1761–72.PubMedCrossRef
50.
Yamazaki S, Fukuhara S, Suzukamo Y. Household income is strongly associated with health-related quality of life among Japanese men but not women. Public Health. 2005;119(7):561–7.PubMedCrossRef
51.
Whelan CT, Maître B. Material deprivation, economic stress, and reference groups in Europe: An analysis of EU-SILC 2009. Eur Sociol Rev. 2013;29(6):1162–74.CrossRef
Metadata
Title
The effect of subjective and objective social class on health-related quality of life: new paradigm using longitudinal analysis
Authors
Young Choi
Jae-Hyun Kim
Eun-Cheol Park
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2015
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/s12955-015-0319-0

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