Socioeconomic status as the strongest predictor of self-rated health in Iranian population; a population-based cross-sectional study

J Psychosom Res. 2019 Sep;124:109775. doi: 10.1016/j.jpsychores.2019.109775. Epub 2019 Jul 8.


Background: There is little evidence comparing the role of subjective versus objective indicators of socioeconomic status (SES) on individuals' self-rated health (SRH) in Iran.

Objectives: We aimed to investigate underlying predictors of SRH including subjective and objective SES in Tehran, a multi-ethnic city.

Method: This is an analysis of cross-sectional survey data on subjective and objective SES from a population-based case-control study conducted in Tehran, Iran (2015). We used random digit dialing for study sample recruitment. Linear regression models were used for estimating crude and adjusted coefficients (95% confidence intervals). Age, gender, SES as well as cigarette smoking were included as confounders.

Results: 15-50 years old residents of Tehran were recruited in the study (n = 1057). High reported objective and subjective SES was consistently associated with a better SRH. Subjective current SES (p < .001), subjective adolescence SES (p = .018), change in subjective SES (current vs. adolescent) (p = .034) and participants' education years (p < .001). Improvements over time in current SES in comparison to SES rated during adolescence increased the participants' SRH after adjustment for potential confounders (coefficient = 0.170, 95% CI: (0.015, 0.325)). Female participants (coefficient = -0.305, 95% CI: (-0.418, -0.192)) and smokers (high category vs. never smokers) (coefficient = -0.456, 95% CI: (-0.714, -0.197)) reported significantly worse SRH. Increasing age - 0.008 (95% CI: -0.014, -0.002) was associated with decreased SRH.

Conclusion: High subjective and objective SES consistently was the most important predictor of high SRH.

Keywords: Cross-sectional study; Population-based; Self-rated health; Socioeconomic status.

MeSH terms

  • Adolescent
  • Adult
  • Cross-Sectional Studies
  • Female
  • Health Status*
  • Humans
  • Iran
  • Male
  • Middle Aged
  • Self Report*
  • Social Class*
  • Young Adult