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APHA Scientific Session and Event Listing

Subjective social status, objective social status, and health in low income Mexican-Americans

Luisa Franzini, PhD, Management, policy and community health, University of Texas School of Public Health, 1200 Pressler Drive, Houston, TX 77401, 713 500 9487, Luisa.Franzini@uth.tmc.edu and Maria Eugenia Fernandez Esquer, PhD, Behavioral Sciences, University of Texas School of Public Health, Pressler Drive, Houston, TX 77030.

There is only limited research on subjective social status (SSS) and its effect on health in general and in minority U.S. populations in particular. This study explores the relationships of SSS to self-reported physical health, self-reported mental health, and self-rated health. Interviews were completed with 1,745 Mexican-origin individuals living in low income neighborhoods in Texas and grouped into four acculturation categories: Spanish speaking immigrants, Spanish speaking US-born, English speaking immigrants, and English speaking US-born. Physical and mental health were measured by the physical health and mental health components of the SF-12. Several measures of objective social status (OSS) were collected: educational attainment, income, work status, and reliance on assistance, home and car ownership. The main measure of SSS was the McArthur self-anchoring scale in the form of a 10 rung ladder developed by Adler. Sociocultural personal characteristics were measured by scales validated in the literature and include measures of religiosity, social support, perceived racism, perceived victimization, perceived personal opportunity, and trust. Descriptive statistics, ANOVA and Bonferroni pair-wise comparisons, chi-square tests, and Kruskal-Wallis tests were used as appropriate to compare OSS, SSS, health outcomes, and sociocultural characteristics in the four acculturation categories. Hierarchical multiple regressions modeled the relationships between health outcomes and demographics, acculturation, OSS, SSS, and sociocultural factors. SSS was associated with all health outcomes when OSSS is not controlled for. When controlling for objective status, subjective status was associated with mental health and self-rated health but not with physical health. These results are consistent with the literature that found, after controlling for OSS, the ladder associated with most psychological well-being indictors and with self-reported health, but not with physical health outcomes. On the other hand, income and work status were consistently associated with physical and mental health in all our models, indicating the prominence of OSS in affecting physical and mental health outcomes in this low income population. These results support the contention that material resources such as income are more important to health in economically disadvantaged groups. It has been argued that explanations for the complex relationship between both OSS and SSS and health lie in SES based differences in sociocultural characteristics. Sociocultural characteristics appear to mediate the effect of subjective social status on health. In particular, perceived victimization might mediate the effect of subjective social status on mental health. This study also investigates the determinants of subjective social status and the comparison groups used in determining SSS.

Learning Objectives: At the conclusion of the session, the participant will be able to

Presenting author's disclosure statement:

Not Answered

Medical Care Poster Session: Quality Improvement, Ethnic & Racial Disparities

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA