The impact of subjective and objective social status on psychological distress among men and women in Japan
Abstract
From around 1990s, social disparity issues and their effects on mental health have been gaining increasing attention in Japanese society. Findings from previous studies on socioeconomic status (SES) and mental health in Japan are inconsistent. Subjective Social Status (SSS) has been proposed and tested as a stronger predictor of mental health than measures such as education, income and occupation in the UK and US, but this has not been tested enough in countries with a different social and cultural background such as Japan. In the present study, a cross-sectional questionnaire survey was conducted in 2006 among a nationally representative community-based random sample of residents in Japan aged 20-74 years. A total of 1237 participants completed the questionnaire, with the overall response rate of 61.9%. After excluding 42 respondents, data from 1195 respondents (574 men and 621 women) were analyzed. SSS, household income, and education level of respondents were measured using single-item questions. Those with a K6 score of 5 or greater were defined as having psychological distress. A multiple logistic regression model was used to examine the effects of SSS, household income, and education on psychological distress. Among men, the prevalence of psychological distress, after adjusting for age and marital status, differed significantly across groups classified based on SSS, household income, and education. Among women, only SSS was significantly associated with psychological di…
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Subjective social status was measured using a question about five strata, a type of assessment widely used and shown to correlate with objective indicators such as household income.
“Subjective social status was measured using the question, “If Japanese/US/Indian society were divided into five strata, which stratum do you suppose your household would belong to?””
From Digital health literacy and trust in health information sources: A comparative study of university students in Japan, the United States, and India (2025) · cites this paper as Sakurai et al., 2010
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Self-citationSocioeconomic status and health: the role of subjective social status
Demakakos, P., Nazroo, J., Breeze, E., & Marmot, M. (2008) · Social Science & Medicine · doi:10.1016/j.socscimed.2008.03.038 · Cited by 719 · see citing works
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Ishikawa, H., Miyawaki, R., Kato, M., Muilenburg, J. L., Tomar, Y. A., & Kawamura, Y. (2025) · SSM - Population Health · doi:10.1016/j.ssmph.2025.101844 · Cited by 17 · see citing works
Self-citationSuka, M., Yamauchi, T., & Yanagisawa, H. (2019) · Environmental Health and Preventive Medicine · doi:10.1186/s12199-019-0786-8 · Cited by 11 · see citing works
- Authors
- Sakurai, K., Kawakami, N., Yamaoka, K., Ishikawa, H., & Hashimoto, H.
- Affiliations
- The University of Tokyo (JP)
- National Institute of Public Health (JP)
- Shiga University of Medical Science (JP)
- Corresponding author
- Sakurai, Keiko
- Venue
- Social Science & Medicine
- Publisher
- Elsevier BV
- Published
- 2010-06
- Volume
- 70
- Issue
- 11
- Pages
- 1832-1839
- ISSN
- 0277-9536 (ISSN-L)
- OpenAlex
- W1987342699
- Cited by
- 128
- References
- 5
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 10 · 2023: 7 · 2022: 10 · 2021: 10 · 2020: 11 · 2019: 11 · 2018: 5 · 2017: 8 · 2016: 10 · 2015: 13 · 2014: 7 · 2013: 5 · 2012: 6
- FWCI
- 4.60
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Social Science & Medicine (publishedVersion)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Institutional Repositories DataBase (IRDB) (submittedVersion)
- Funders
- National Institute on Minority Health and Health Disparities
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Health Professions › General Health Professions › Employment and Welfare Studies
- Social Sciences › Psychology › Social Psychology › Psychological Well-being and Life Satisfaction
- Keywords
- subjective social status, psychological distress, socioeconomic status, household income, educational attainment, gender differences, mental health, social inequality, Japanese population
- MeSH terms
- Adult, Aged, Cross-Sectional Studies, Female, Humans, Japan, Male, Middle Aged, Surveys and Questionnaires, Sex Factors, Social Class, Socioeconomic Factors, Stress, Psychological, Logistic Models, Odds Ratio
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