International Journal of Behavioral Medicine

, Volume 21, Issue 1, pp 53-65

First online:

Psychological Resources as Mediators of the Association Between Social Class and Health: Comparative Findings from Japan and the USA

  • Chiemi KanAffiliated withThe University of Tokyo Email author 
  • , Norito KawakamiAffiliated withThe University of Tokyo
  • , Mayumi KarasawaAffiliated withTokyo Woman’s Christian University
  • , Gayle Dienberg LoveAffiliated withUniversity of Wisconsin
  • , Christopher L. CoeAffiliated withUniversity of Wisconsin
  • , Yuri MiyamotoAffiliated withUniversity of Wisconsin
  • , Carol D. RyffAffiliated withUniversity of Wisconsin
  • , Shinobu KitayamaAffiliated withUniversity of Michigan
  • , Katherine B. CurhanAffiliated withStanford University
    • , Hazel Rose MarkusAffiliated withStanford University

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Recently, researchers have proposed that psychological resources might be key concept in explaining the association between social class and health. However, empirical examinations of the extent to which psychological resources to social class in health are still few.


This study investigated mediating effects of selected psychological resources (sense of control, self-esteem, optimism, and neuroticism) on the association of social class [education and subjective social status (SSS)] with current health status (self-rated health and the number of chronic conditions).


This sample consisted of 1,805 Americans (818 males and 987 females) from the Midlife in the United States (MIDUS) survey, 2004–2006 and 1,027 Japanese (505 males and 522 females) from the Midlife in Japan (MIDJA) survey in Tokyo, Japan, 2008–2010. Information on social class, psychological resources, and health status was obtained using telephone interviews or written questionnaires.


A mediation analysis was conducted separately for males and females in Japan and the USA. Neuroticism significantly mediated the association of education and SSS with self-rated health and chronic conditions among males and females in both countries, with one exception (not for chronic conditions among Japanese females). Sense of control significantly mediated the association of education and SSS with self-rated health among males and females in both countries. As hypothesized, self-esteem significantly mediated almost all of the associations of education and SSS with self-rated health and chronic conditions among men and women in the USA, but very few such associations in Japan. Optimism significantly mediated most associations of social class and health status in both countries, but only among females.


Overall, the findings underscore important culture- and gender specificity in the ways in which psychosocial resources mediate the links between social class and health.


Socioeconomic status Sense of control Self-esteem Neuroticism Optimism Mediation analysis