Role of subjective social status in the social gradients in health among older adults in Mexico

Objective: SES characteristics are consistent and powerful predictors of health across a variety of health outcomes. Alternative measures such as subjective social status (SSS) have recently been used to elucidate social gradients in health in developed countries. It is less known if SSS plays a predictive role in health inequalities in developing countries such as Mexico. In this study, we explore the association between SSS and health outcomes in a national sample from the 2003 wave of the Mexican Health and Aging Study (MHAS).

Methods: The study included 5,476 Mexicans aged 52 and older from the MHAS. The average age was 65.3 (SD 8.6), 55% were female, and 50% were married. SSS was measured with the MacArthur Scale of Subjective Social Status at three levels (household, community, and country). Health outcomes included a measure of global self-rated health and depressive symptoms using a modified version of the CES-D. Logistic regression models were used to explore the role of SSS.

Results: The mean household-SSS ranking was 8.4 (SD 2.2), whereas the mean Mexico-SSS ranking was 5.1 (SD 3.2). Eighteen percent of the sample reported depressive symptoms and 66.9% reported fair/poor self-rated health. SSS from the household, community, and country level were consistently associated with self-rated health (p<.001) and depressive symptoms (p<.001). SSS is a moderator for both self-rated health and depressive symptoms.

Implications: Findings suggest that SSS captures an aspect of social status not explained by SES measures. The results also provide evidence of the analytical usefulness of SSS in Mexico.