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Meta-Analysis
. 2017 Dec;36(12):1109-1125.
doi: 10.1037/hea0000534. Epub 2017 Jul 20.

Is subjective social status a unique correlate of physical health? A meta-analysis

Jenny M Cundiff  1 , Karen A Matthews  2
Affiliations
Meta-Analysis

Is subjective social status a unique correlate of physical health? A meta-analysis

Jenny M Cundiff et al. Health Psychol. 2017 Dec.

Abstract

Objective: Both social stratification (e.g., social rank) as well as economic resources (e.g., income) are thought to contribute to socioeconomic health disparities. It has been proposed that subjective socioeconomic status (an individual's perception of his or her hierarchical rank) provides increased predictive utility for physical health over and above more traditional, well-researched socioeconomic constructs such as education, occupation, and income.

Method: PsycINFO and PubMed databases were systematically searched for studies examining the association of subjective socioeconomic status (SES) and physical health adjusting for at least 1 measure of objective SES. The final sample included 31 studies and 99 unique effects. Meta-analyses were performed to: (a) estimate the overlap among subjective and objective indicators of SES and (b) estimate the cumulative association of subjective SES with physical health adjusting for objective SES. Potential moderators such as race and type of health indicator assessed (global self-reports vs. more specific and biologically based indicators) were also examined.

Results: Across samples, subjective SES shows moderate overlap with objective indicators of SES, but associations are much stronger in Whites than Blacks. Subjective SES evidenced a unique cumulative association with physical health in adults, above and beyond traditional objective indicators of SES (Z = .07, SE = .01, p < .05). This association was stronger for self-rated health than for biologically based and symptom-specific measures of health. Almost all available data were cross-sectional and do not allow for strong causal inference.

Conclusions: Subjective SES may provide unique information relevant to understanding disparities in health, especially self-rated health. (PsycINFO Database Record

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Figures

Figure 1
Figure 1
Flow chart showing inclusion/exclusion of studies identified from initial search.
Figure 2
Figure 2
Forest plot for effects aggregated within samples (K=31).
Figure 3
Figure 3
Forest plots for all effects by type of outcome.
Figure 3
Figure 3
Forest plots for all effects by type of outcome.
Figure 4
Figure 4
Funnel plot examining the likelihood of publication bias. Open circles are observed values and black circles are values imputed in order to correct for potential publication bias.
Figure 5
Figure 5
Pictorial summary of the cumulative association of subjective SES with physical health independent of objective SES.
See this image and copyright information in PMC

References

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