Cited by 719Health disparities and outcomesPublic Health and Social InequalitiesAging, Health, and Disability

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Socioeconomic status and health: The role of subjective social status

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Demakakos, Panayotes, Nazroo, James, Breeze, Elizabeth, Marmot, Michael·2008·Social Science & Medicine

DOI 10.1016/j.socscimed.2008.03.038PMC PMC2547480

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Abstract

Studies have suggested that subjective social status (SSS) is an important predictor of health. This study examined the link between SSS and health in old age and investigated whether SSS mediated the associations between objective indicators of socioeconomic status and health. It used cross-sectional data from the second wave (2004-2005) of the English Longitudinal Study of Ageing, which were collected through personal interviews and nurse visits. The study population consisted of 3368 men and 4065 women aged 52 years or older. The outcome measures included: self-rated health, long-standing illness, depression, hypertension, diabetes, central obesity, high-density lipoprotein cholesterol, triglycerides, fibrinogen, and C-reactive protein. The main independent variable was SSS measured using a scale representing a 10-rung ladder. Wealth, education, and occupational class were employed as covariates along with age and marital status and also, in additional analyses, as the main independent variables. Gender-specific logistic and linear regression analyses were performed. In age-adjusted analyses SSS was related positively to almost all health outcomes. Many of these relationships remained significant after adjustment for covariates. In men, SSS was significantly (p<or=0.05) related to self-rated health, depression, and long-standing illness after adjustment for all covariates, while its association with fibrinogen became non-significant. In women, after adjusting for all covariates, SSS was significantly associated with self-rated health, depression, long-standing illness, diabetes, and high-density lipoprotein cholesterol, but its associations with central obesity and C-reactive protein became non-significant. Further analysis suggested that SSS mediated fully or partially the associations between education, occupational class and self-reported and clinical health measures. On the contrary, SSS did not mediate wealth's associations with the outcome measures, except those with self-reported health measures. Our results suggest that SSS is an important correlate of health in old age, possibly because of its ability to epitomize life-time achievement and socioeconomic status.

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Wu, Z., Zhang, J., Jiang, M., Zhang, J., & Xiao, Y.-W. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1167740 · Cited by 6
Change in subjective social status following HIV diagnosis and associated effects on mental and physical health among HIV-positive gay men in Australia
Heywood, W., & Lyons, A. (2017) · Psychology and Health · doi:10.1080/08870446.2017.1307374 · Cited by 6
“, 2000) or that subjective social status may partially mediate (or explain) the relationship between objective measures of socio-economic status and health (Demakakos et al., 2008).”
BackgroundInfluential
Negative perception of socioeconomic status with depressive mood down-regulates expression of PPBP and SLC1A7 genes in peripheral blood leukocytes
Fujita, K., Kuwano, Y., Saijo, S., Nishikawa, T., Nishida, K., & Rokutan, K. (2017) · Cogent Psychology · doi:10.1080/23311908.2017.1338825 · Cited by 6
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for the GENESIS-PRAXY investigators, Tang, K. L., Pilote, L., Behlouli, H., Godley, J., & Ghali, W. A. (2018) · BMC Cardiovascular Disorders · doi:10.1186/s12872-018-0759-7 · Cited by 6
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“…research has found that, at least among adults, subjective social status is more strongly correlated with wealth compared to education or occupation, and that subjective social status mediates the association between net worth and self-rated health among British adults (Demakakos et al., 2008).”
The Role of the Digital Economy in Promoting Sustainable Agricultural Development: Implications for Sustainable Food Security
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“Subjective social status reflects an individual’s self-assessed position within the social hierarchy and sense of belonging [41].”
Gender differences in the association between childhood socioeconomic status and later-life depression among middle-aged and older adults in China: A chain mediation model of education level and present subjective social status
Xu, J., Jiang, X., Sun, J., Zuo, X., Cheng, F., Bobkov, A., Tian, G., Kang, Z., & Wang, L. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.04.103 · Cited by 5
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“Socioeconomic status is another important determinant of longevity, including both current and perceived socioeconomic status [20] and socioeconomic conditions during early life [21].”
Building a good-neighbourly relationship: The impact of neighbourhood social capital on the subjective well-being of migrant elderly in China
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Exploring the relationship between multiple dimensions of subjective socioeconomic status and self-reported physical and mental health: the mediating role of affect
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“One such explanation is the averaging hypothesis (65, 66), which suggests that objective SES indicators, such as income and education, often capture limited static and current socioeconomic resources and adversities that may influence health outcomes.”
Background
Socioeconomic inequalities in physical activity among older adults before and during the COVID-19 pandemic: evidence from the English Longitudinal Study of Ageing
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Sato, M., Tsuji, T., Ueno, T., Watanabe, R., Ide, K., & Kondo, K. (2024) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.6069 · Cited by 5
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Daker‐White, G., Sanders, C., Rogers, A. E., Vassliev, I., Blickem, C., & Cheraghi‐Sohi, S. (2014) · SAGE Open · doi:10.1177/2158244014558041 · Cited by 5
“The effect of SSS on health, depression, illness, and disability was greater than that of occupation, wealth, marital status, and age (Demakakos et al., 2008, p. 7).”
Influential
Diabetes in China and the Western Pacific Region
Chan, J. C. N., Chow, E., & Luk, A. O. Y. (2016) · Springer eBooks · doi:10.1007/978-3-319-41559-8_5 · Cited by 5
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Lucas, J., Ho, H.-Y., & Kerns, K. (2017) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780190243470.013.15 · Cited by 4
Market Transition, Multidimensional Socioeconomic Status, and Health Disparities in Urban China
Xu, J., Zhao, W., & Gong, F. (2020) · Sociological Perspectives · doi:10.1177/0731121420937732 · Cited by 5
“In addition to these objective measures of SES, recent scholarship has indicated that subjective SES plays a key role in predicting various health outcomes (Demakakos et al. 2008; SinghManoux, Adler, and Marmot 2003).”
Background
Coronary microvascular and endothelial function regulation: Crossroads of psychoneuroendocrine immunitary signals and quantum physics [Part C]
Lin, C. D., Poretto, A., Scodro, M., Marra, M. P., Iliceto, S., & Tona, F. (2015) · Journal of Integrative Cardiology · doi:10.15761/jic.1000137 · Cited by 5
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Neubert, M., Süssenbach, P., & Euteneuer, F. (2022) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2022.111065 · Cited by 5
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“However, this previous research had focused on the introduction of the QOF whose impact was notably larger (Doran et al. (2011)).”
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Sue-Lynn, K., Kim, J., & Ju, K. (2019) · Asian Social Work and Policy Review · doi:10.1111/aswp.12174 · Cited by 5
Subjective Socioeconomic Status and Self-Rated Health in the English Longitudinal Study of Aging: A Fixed-Effects AnalysisPreprint
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“One possible explanation is that subjective poverty may mediate the long-term impact of economic poverty on life satisfaction (Demakakos et al., 2008).”
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“Subjective social status (SSS) was assessed using an adapted version of the Macarthur Scale of Subjective Social Status, which depicts a 10-rung ladder representing where people stand in their community (Demakakos et al., 2008).”
Method
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“These associations have been found to persist even when statistically accounting for socioeconomic indicators, such as income, education and occupational prestige confirming the usefulness of the subjective measure [65].”
Background
Information About Inequality of Opportunity Increases Downward Mobility Perceptions: A Population-Wide Randomized Survey Experiment
Gugushvili, A. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.868303 · Cited by 4
“org 6 May 2022 | Volume 13 | Article 868303 social psychology, and political science (Demakakos et al., 2008; Gidron and Hall, 2017; Zell et al., 2018).”
Background
Interactive effects of financial strain and distress tolerance on prequit tobacco withdrawal symptoms in smokers preparing to initiate a quit attempt.
Bello, M. S., Pang, R. D., Colby, S. M., Cassidy, R. N., Zvolensky, M. J., & Langdon, K. J. (2023) · Experimental and Clinical Psychopharmacology · doi:10.1037/pha0000639 · Cited by 5
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“Economic activity in older adulthood not only ensures financial abundance but also has a positive impact on health (24), and economic status is an important predictor of physical health, mental health, and SRH (25).”
Divine Relations as a Basis of Subjective Social Status During Later‐Life: Direct and Moderating Effects
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The Moderating Effect of Values on the Relationship between Subjective Social Status and Depression: Evidence from MIDUS
Ekl, E. A., & Gallati, B. (2023) · Society and Mental Health · doi:10.1177/21568693231184282 · Cited by 4
“Empirical findings show that the higher one’s SSS, the less likely one is to experience depression (Demakakos et al. 2008; Eutene-uer 2014).”
Influential

Authors: Demakakos, P., Nazroo, J., Breeze, E., & Marmot, M.
Affiliations: University College London (GB)
University of Manchester (GB)
Corresponding author: Demakakos, Panayotes
ORCID: Demakakos, Panayotes
Nazroo, James
Breeze, Elizabeth
Marmot, Michael
Venue: Social Science & Medicine
Publisher: Elsevier BV
Published: 2008-07
Volume: 67
Issue: 2
Pages: 330-340
ISSN: 0277-9536 (ISSN-L)
DOI: 10.1016/j.socscimed.2008.03.038
PMC: PMC2547480
OpenAlex: W2032784487
Cited by: 719
References: 46
Citations by year: 2026: 31 · 2025: 52 · 2024: 54 · 2023: 53 · 2022: 55 · 2021: 51 · 2020: 36 · 2019: 41 · 2018: 50 · 2017: 45 · 2016: 40 · 2015: 32 · 2014: 41 · 2013: 30 · 2012: 32
FWCI: 26.58
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Social Science & Medicine (publishedVersion)
PubMed (publishedVersion)
Research Explorer (The University of Manchester) (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
RePEc: Research Papers in Economics (submittedVersion)
UCL Discovery (University College London) (submittedVersion)
Funders: British Heart Foundation (RG/07/008/23674)
Economic and Social Research Council (RES-000-23-0590)
National Institute on Aging (2R01AG7644-01A1, R01AG013196, R01AG017644)
Topics: Social Sciences › Health › Health disparities and outcomes
Social Sciences › Health › Public Health and Social Inequalities
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
Keywords: subjective social status, socioeconomic status, elderly health, self-rated health, depression, chronic disease, mediation, occupational class, wealth, gender differences, fibrinogen, C-reactive protein, English Longitudinal Study of Ageing
MeSH terms: Aged, Aged, 80 and over, Cross-Sectional Studies, Female, United Kingdom, Health Status Indicators, Humans, Interviews as Topic, Longitudinal Studies, Male, Middle Aged, Social Class

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Socioeconomic status and health: The role of subjective social status

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