Socioeconomic Status Association With Dependency From Objective and Subjective Assessments: A Cross-Sectional Study

Abstract

Background: The effect of socioeconomic status (SES) on dependency is still complex and not fully clear. The purposes of this study are to assess the association between SES and dependency personality disorder (DPD) using both objective and subjective assessments.

Methods: A cross-sectional study was conducted in 27 locations in China among 1,276 general residents aged 60 years and above through a complex multistage sampling design. Data were collected using a questionnaire by well-trained investigators through face-to-face interviews. The DPD was assessed using a standardized Chinese version of the Minnesota Multiphasic Personality Inventory-II scale. Objective SES was assessed by the combination of education levels, individual income, preretirement occupation, and medical insurance. Subjective SES was measured using the MacArthur Scale. The logistic regression analysis was used to evaluate the association between objective SES and DPD. Analysis of covariance was conducted to compare the mean of DPD scores in different levels of SES.

Results: The results of the chi-squared test showed that the levels of objective SES were associated with DPD, depression, social resources, and region. The logistic regression analysis showed a significant negative association between the levels of objective SES and DPD. The odds ratio was 1.84 (95% confidence interval, 1.07-3.18) after adjusting for important confounding factors. The analysis of covariance showed differences in the mean of DPD scores among different groups defined by different levels of SES.

Conclusion: The levels of SES were negatively associated with DPD, and subjective SES had a stronger association with DPD than objective SES. The effect of subjective SES on DPD is possibly associated with the perception of position in the social hierarchy.

Keywords: dependency; elderly people; objective and subjective assessments; social resources; socioeconomic status.

Figure 1

Sampling designs in the study.

Figure 2

The subjective social status was measured using the MacArthur scale. (1) Here is a ladder. Think of this ladder representing where people stand in Zhejiang Province. At the top of the ladder are the people who are the best off—those who have the most money, the most education, and the most respected jobs. At the bottom are the people who are the worst off—who have the least money, the least education, and the least respected jobs or no jobs. The higher up you are on this ladder, the closer you are to the people at the very top, and the lower you are, the closer you are to the people at the very bottom. If you consider your current situation and compare it with all other people in Zhejiang Province, where would you place yourself on this ladder? Please mark an X on the rung that best represent your situation. (2) Here is another ladder. Think of this ladder as representing where people stand in the people around them. At the top of the ladder are the people who are the best off—those who have the most money, most education, and best jobs. At the bottom are the people who are the worst off—those who have the least money, least education, and worst jobs or no job. If you consider your current situation and compare it with all the people around you, where would you place yourself on this ladder? Please mark an X on the rung that best represent your situation.