Subjective socio-economic status predicts self-rated health irrespective of objective family socio-economic background

Scand J Public Health. 2020 Nov;48(7):707-714. doi: 10.1177/1403494820926053. Epub 2020 Jun 7.

Abstract

Aim: Subjective appraisals of socio-economic status (SES) are robustly associated with health outcomes, even when controlling for objective SES. Is this because objective SES is not accounted for in a sufficiently exhaustive way? Methods: I pool eight waves of nationally representative survey data from Germany (German General Social Survey, 2004-18, N=13,557) to assess the association between two separate subjective appraisals of SES (a 10-point scale and subjectively chosen social class membership) and poor self-rated health using logit and linear probability models. I account for an exhaustive range of objective SES variables, including respondents' household incomes and social status, as well as occupational status, social class and education of respondents and of their partners, fathers and mothers. Results: The association between subjective SES and poor self-rated health remains stable, even when accounting for a wide range of objective SES markers. This is true for both subjective SES measured on a 10-point scale and as a subjective class identification. Conclusions: Even when controlling for a large number of objective SES markers, subjective SES and self-rated health are linked, suggesting that subjective assessments of SES are meaningful measures of SES which form a distinct pathway to health.

Keywords: Subjective social status; self-rated health; social determinants of health; subjective social location; subjective socio-economic position.

MeSH terms

  • Adult
  • Aged
  • Diagnostic Self Evaluation*
  • Family
  • Female
  • Germany
  • Humans
  • Male
  • Middle Aged
  • Social Class*
  • Socioeconomic Factors