International Journal of Behavioral Medicine

, Volume 21, Issue 1, pp 53–65 | Cite as

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

  • Chiemi Kan
  • Norito Kawakami
  • Mayumi Karasawa
  • Gayle Dienberg Love
  • Christopher L. Coe
  • Yuri Miyamoto
  • Carol D. Ryff
  • Shinobu Kitayama
  • Katherine B. Curhan
  • Hazel Rose Markus



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 



This research was supported by a grant from the National Institute on Aging (5R37AG027343) to conduct a study of Midlife in Japan (MIDJA) for comparative analysis with MIDUS (Midlife in the United States, P01-AG020166). The data analysis and preparation of the manuscript was supported by a Grant-in-Aid for Scientific Research (A) 2009-2013 (No. 20240062) from the Ministry of Education, Culture, Sports, Science and Technology, Japan.


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Copyright information

© International Society of Behavioral Medicine 2012

Authors and Affiliations

  • Chiemi Kan
    • 1
  • Norito Kawakami
    • 1
  • Mayumi Karasawa
    • 2
  • Gayle Dienberg Love
    • 3
  • Christopher L. Coe
    • 3
  • Yuri Miyamoto
    • 3
  • Carol D. Ryff
    • 3
  • Shinobu Kitayama
    • 4
  • Katherine B. Curhan
    • 5
  • Hazel Rose Markus
    • 5
  1. 1.The University of TokyoTokyoJapan
  2. 2.Tokyo Woman’s Christian UniversityTokyoJapan
  3. 3.University of WisconsinMadisonUSA
  4. 4.University of MichiganAnn ArborUSA
  5. 5.Stanford UniversityStanfordUSA

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