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Beyond conventional socioeconomic status: examining subjective and objective social status with self-reported health among Asian immigrants

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Abstract

Despite mounting evidence for a strong and persistent association between socioeconomic status (SES) and health, this relationship is largely unknown among Asian immigrants, a fast growing minority group in the US population. Previous research has typically focused on objective SES (primarily education and income) and ignored self-perceived SES. Using data from the National Latino and Asian American Study (NLAAS) (N = 1,570), we examined the impact of subjective as well as objective SES upon multiple self-reported health outcomes among Asian immigrants. Results indicated that conventional SES indicators by and large were non-significantly related to self-rated physical health, physical discomfort, self-rated mental health, and psychological distress. In contrast, subjective SES relative to people in the United States and people in the community showed strong associations with health outcomes above and beyond conventional SES markers. This study suggested a promising avenue to incorporate subjective SES in health disparities research, especially among immigrants.

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References

  • Adler, N. E., Boyce, T., Chesney, M. A., Cohen, S., Folkman, S., Kahn, R. L., et al. (1994). Socioeconomic status and health: The challenge of the gradient. American Psychologist, 49, 15–24. doi:10.1037//0003-066X.49.1.15

    Article  PubMed  CAS  Google Scholar 

  • Adler, N. E., Epel, E. S., Castellazzo, G., & Ickovics, J. R. (2000). Relationship of subjective and objective social status with psychological and physiological functioning: Preliminary data in healthy white women. Health Psychology, 19, 586–592. doi:10.1037//0278-6133.19.6.586

    Article  PubMed  CAS  Google Scholar 

  • Adler, N. E., & Rehkopf, D. H. (2008). U.S. Disparities in health: Descriptions, causes, and mechanisms. Annual Review of Public Health, 29, 235–252. doi:10.1146/annurev.publhealth.29.020907.090852

    Article  PubMed  Google Scholar 

  • Adler, N. E., & Stewart, J. (2007). The MacArthur scale of subjective social status. Retrieved from http://www.macses.ucsf.edu/research/psychosocial/subjective.php

  • Alegria, M., Takeuchi, D. T., Ganino, G., Duan, N., Shrout, P., Meng, X. L., et al. (2004). Considering context, place, and culture: The National Latino and Asian American Study. International Journal of Methods in Psychiatric Research, 13, 208–220. doi:10.1002/mpr.178

    Article  PubMed  Google Scholar 

  • Andrews, G., & Slade, T. (2001). Interpreting scores on the Kessler psychological distress scale (k10). Australia New Zealand Journal of Public Health, 25, 494–497. doi:10.1111/j.1467-842X.2001.tb00310.x

    Article  CAS  Google Scholar 

  • Banks, J., Marmot, M., Oldfield, Z., & Smith, J. P. (2006). Disease and disadvantage in the United States and in England. JAMA, 295, 2037–2045. doi:10.1001/jama.295.17.2037

    Article  PubMed  CAS  Google Scholar 

  • Baron-Epel, O., & Kaplan, G. (2009). Can subjective and objective socioeconomic status explain minority health disparity in Israel? Social Science and Medicine, 69, 1460–1467. doi:10.1016/j.socscimed.2009.08.028

    Article  PubMed  Google Scholar 

  • Braveman, P. A. (2006). Health disparities and health equity: Concepts and measurement. Annual Review of Public Health, 27, 167–194. doi:10.1146/annurev.publhealth.27.021405.102103

    Article  PubMed  Google Scholar 

  • Braveman, P. A., Cubbin, C., Egerter, S., Williams, D. R., & Pamuk, E. (2010). Socioeconomic disparities in health in the United States: What the patterns tell us. American Journal of Public Health, 100, S186–S196. doi:10.2105/AJPH.2009.166082

    Article  PubMed  Google Scholar 

  • Cho, Y., Frisbie, W. P., Hummer, R. A., & Rogers, R. G. (2004). Nativity, duration of residence, and the health of Hispanic adults in the United States. International Migration Review, 38, 184–211. doi:10.1111/j.1747-7379.2004.tb00193.x

    Article  Google Scholar 

  • Cohen, S., Alper, C. M., Doyle, W. J., Adler, N., Treanor, J. J., & Turner, R. B. (2008). Objective and subjective socioeconomic status and susceptibility to the common cold. Health Psychology, 27, 268–274. doi:10.1037/0278-6133.27.2.268

    Article  PubMed  Google Scholar 

  • Collins, A. L., & Goldman, N. (2008). Perceived social position and health in older adults in Taiwan. Social Science and Medicine, 66, 536–544. doi:10.1016/j.socscimed.2007.10.004

    Article  PubMed  Google Scholar 

  • Conrad, P., & Barker, K. K. (2010). The social construction of illness. Journal of Health and Social Behavior, 51, S67–S79. doi:10.1177/0022146510383495

    Article  PubMed  Google Scholar 

  • de Castro, A. B., Gee, G. C., & Takeuchi, D. T. (2010). Examining alternative measures of social disadvantage among Asian Americans: The relevance of economic opportunity, subjective social status, and financial strain for health. Journal of Immigrant and Minority Health, 12, 659–671. doi:10.1007/s10903-009-9258-3

    Article  PubMed  Google Scholar 

  • Deaton, A. (2001). Relative deprivation, inequality, and mortality. Cambridge, MA: National Bureau of Economic Research.

    Google Scholar 

  • Demakakos, P., Nazroo, J., Breeze, E., & Marmot, M. (2008). Socioeconomic status and health: The role of subjective social status. Social Science and Medicine, 67(2), 330–340. doi:10.1016/j.socscimed.2008.03.038

    Article  PubMed  Google Scholar 

  • Frisbie, W. P., Cho, Y., & Hummer, R. A. (2001). Immigration and the health of Asian and Pacific Islander adults in the United States. American Journal of Epidemiology, 153, 372–380. doi:10.1093/aje/153.4.372

    Article  PubMed  CAS  Google Scholar 

  • Gianaros, P. J., Shorenstein, J. A., Cohen, S., Matthews, K. A., Brown, S. M., Flory, J. D., et al. (2007). Perigenual anterior cingulate morphology covaries with perceived social standing. Social Cognitive and Affective Neuroscience, 2, 161–173.

    Article  PubMed  Google Scholar 

  • Gong, F., Takeuchi, D. T., Agbayani-Siewert, P., & Tacata, L. (2003). Acculturation, psychological distress and alcohol use: Investigating the effects of ethnic identity and religiosity. In K. M. Chun, P. B. Organista, & G. Marin (Eds.), Acculturation: Advances in theory, measurement, and applied research (pp. 189–206). Washington, DC: American Psychological Association. doi:10.1037/10472-012

    Chapter  Google Scholar 

  • Goodman, E., Adler, N. E., Daniels, S. R., Morrison, J. A., Slap, G. B., & Dolan, L. M. (2003). Impact of objective and subjective social status on obesity in a biracial cohort of adolescents. Obesity Research, 11, 1018–1026. doi:10.1038/oby.2003.140

    Article  PubMed  Google Scholar 

  • Goodman, E., Huang, B., Schafer-Kalkhoff, T., & Adler, N. E. (2007). Perceived socioeconomic status: A new type of identity that influences adolescents’ self-rated health. Journal of Adolescent Health, 41, 479–487. doi:10.1016/j.jadohealth.2007.05.020

    Article  PubMed  Google Scholar 

  • Grieco, E. M. (2010). Race and Hispanic origin of the foreign-born population in the United States: 2007. US Census Bureau. Retrieved from http://www.census.gov/prod/2010pubs/acs-11.pdf

  • Hayward, M. D., Miles, T. P., Crimmins, E. M., & Yang, Y. (2000). The significance of socioeconomic status in explaining the racial gap in chronic health conditions. American Sociological Review, 65, 910–930. doi:10.2307/2657519

    Article  Google Scholar 

  • Heeringa, S. G., Wagner, J., Torres, M., Duan, N., Adams, T., & Berglund, P. (2004). Sample designs and sampling methods for the Collaborative Psychiatric Epidemiology Studies (CPES). International Journal of Methods in Psychiatric Research, 13, 221–240. doi:10.1002/mpr.179

    Article  PubMed  Google Scholar 

  • Hu, P., Adler, N. E., Goldman, N., Weinstein, M., & Seeman, T. E. (2005). Relationship between subjective social status and measures of health in older Taiwanese persons. Journal of the American Geriatrics Society, 53, 483–488. doi:10.1111/j.1532-5415.2005.53169.x

    Article  PubMed  Google Scholar 

  • Humes, K. R., Jones, N. A. & Ramirez, R. R. (2011). Overview of race and Hispanic origin: 2010. 2010 Census Briefs. Retrieved from http://www.census.gov/prod/cen2010/briefs/c2010br-02.pdf

  • Hurh, W. M., & Kim, K. C. (1990). Correlates of Korean immigrants’ mental health. Journal of the Nervous Mental Disease, 178, 703–711. doi:10.1097/00005053-199011000-00006

    Article  CAS  Google Scholar 

  • Idler, E. L., & Benyamini, Y. (1997). Self-rated health and mortality: A review of twenty-seven community studies. Journal of Health and Social Behavior, 38, 21–37. doi:10.2307/2955359

    Article  PubMed  CAS  Google Scholar 

  • Idler, E. L., Hudson, S. V., & Leventhal, H. (1999). The meanings of self-ratings of health. Research on Aging, 21, 458–476. doi:10.1177/0164027599213006

    Article  Google Scholar 

  • Jylhä, M. (2009). What is self-rated health and why does it predict mortality? Towards a unified conceptual model. Social Science and Medicine, 69, 307–316. doi:10.1016/j.socscimed.2009.05.013

    Article  PubMed  Google Scholar 

  • Koh, H. K., Oppenheimer, S. C., Massin-Short, S. B., Emmons, K. M., Geller, A. C., & Viswanath, K. (2010). Translating research evidence into practice to reduce health disparities: A social determinants approach. American Journal of Public Health, 100, S72–S80. doi:10.2105/AJPH.2009.167353

    Article  PubMed  Google Scholar 

  • Kuo, W. H. (1984). Prevalence of depression among Asian-Americans. Journal of the Nervous Mental Disease, 172, 449–457. doi:10.1097/00005053-198408000-00002

    Article  CAS  Google Scholar 

  • Leu, J., Yen, I. H., Gansky, S. A., Walton, E., Adler, N. E., & Takeuchi, D. T. (2008). The association between subjective social status and mental health among Asian immigrants: Investigating the influence of age at immigration. Social Science and Medicine, 66, 1152–1164. doi:10.1016/j.socscimed.2007.11.028

    Article  PubMed  Google Scholar 

  • Link, B. G., & Phelan, J. C. (2000). Evaluating the fundamental cause explanation for social disparities in health. In E. C. Bird, P. Conrad, & A. M. Fremont (Eds.), Handbook of medical sociology (5th ed., pp. 33–46). Upper Saddle River, New Jersey: Prentice-Hall.

    Google Scholar 

  • Mirowsky, J., Ross, C. E., & Reynolds, J. (2000). Links between social status and health status. In E. C. Bird, P. Conrad, & A. M. Fremont (Eds.), Handbook of medical sociology (5th ed., pp. 47–67). Upper Saddle River, New Jersey: Prentice-Hall.

    Google Scholar 

  • Noh, S., & Avison, W. R. (1996). Asian immigrants and the stress process: A study of Koreans in Canada. Journal of Health and Social Behavior, 37, 192–206. doi:10.2307/2137273

    Article  PubMed  CAS  Google Scholar 

  • Noh, S., Beiser, M., Kaspar, V., Hou, F., & Rummens, J. (1999). Perceived racial discrimination, depression, and coping: A study of Southeast Asian refugees in Canada. Journal of Health and Social Behavior, 40, 193–207. doi:10.2307/2676348

    Article  PubMed  CAS  Google Scholar 

  • Operario, D., Adler, N. E., & Williams, D. R. (2004). Subjective social status: Reliability and predictive utility for global health. Psychology and Health, 19, 237–246. doi:10.1080/08870440310001638098

    Article  Google Scholar 

  • Ostrove, J. M., Adler, N. E., Kuppermann, M., & Washington, A. E. (2000). Objective and subjective assessments of socioeconomic status and their relationship to self-rated health in an ethnicity diverse sample of pregnant women. Health Psychology, 19, 613–618. doi:10.1037/0278-6133.19.6.613

    Article  PubMed  CAS  Google Scholar 

  • Piko, B. F., & Fitzpatrick, K. M. (2001). Does class matter? SES and psychosocial health among Hungarian adolescents. Social Science and Medicine, 53, 817–830. doi:10.1016/S0277-9536(00)00379-8

    Article  PubMed  CAS  Google Scholar 

  • Piko, B. F., & Fitzpatrick, K. M. (2006). Socioeconomic status, psychosocial health and health behaviours among Hungarian adolescents. The European Journal of Public Health, 17, 353–360. doi:10.1093/eurpub/ckl257

    Article  Google Scholar 

  • Robert, S. A., & House, J. S. (2000). Socioeconomic inequalities in health: An enduring sociological problem. In E. C. Bird, P. Conrad, & A. M. Fremont (Eds.), Handbook of medical sociology (5th ed., pp. 79–97). Upper Saddle River, New Jersey: Prentice-Hall.

    Google Scholar 

  • Rohrer, J. E. (2004). Medical care usage and self-rated mental health. BMC Public Health, 4, 3. doi:10.1186/1471-2458-4-3

    Article  PubMed  Google Scholar 

  • Schmidley, A. D. (2001). Profile of the foreign-born population in the United States: 2000. U.S. Census Bureau, Current Population Reports (Series P23-206). Government Printing Office, Washington, DC.

  • Schnittker, J., & McLeod, J. D. (2005). The social psychology of health disparities. Annual Review of Sociology, 31, 75–103. doi:10.1146/annurev.soc.30.012703.110622

    Article  Google Scholar 

  • Singh-Manoux, A., Adler, N. E., & Marmot, M. G. (2003). Subjective social status: Its determinants and its association with measures of ill-health in the Whitehall II Study. Social Science and Medicine, 56, 1321–1333. doi:10.1016/S0277-9536(02)00131-4

    Article  PubMed  Google Scholar 

  • Singh-Manoux, A., Marmot, M. G., & Adler, N. E. (2005). Does subjective social status predict health and change in health status better than objective status? Psychosomatic Medicine, 67, 855–861. doi:10.1097/01.psy.0000188434.52941.a0

    Article  PubMed  Google Scholar 

  • Stata Corporation. (2009). Stata survey data reference manual. Release 11. College Station, TX: Stata Press.

    Google Scholar 

  • Takeuchi, D. T., Chung, R. C., Lin, K., Shen, H., Kuraski, K., Chun, C., et al. (1998). Lifetime and twelve-month prevalence rates of major depressive episodes and dysthymia among Chinese Americans in Los Angeles. American Journal of Psychiatry, 155, 1407–1414.

    PubMed  CAS  Google Scholar 

  • Takeuchi, D. T., Zane, N., Hong, S., Chae, D. H., Gong, F., Gee, G. C., et al. (2007). Immigration-related factors and mental disorders among Asian Americans. American Journal of Public Health, 97, 84–90. doi:10.2105/AJPH.2006.088401

    Article  PubMed  Google Scholar 

  • Walton, E., Takeuchi, D. T., Herting, J. R., & Alegría, M. (2009). Does place of education matter? Contextualizing the education and health status association among Asian Americans. Biodemography and Social Biology, 55, 30–51. doi:10.1080/19485560903054648

    Article  PubMed  Google Scholar 

  • Xie, Y., & Goyette, K. (2004). Asian Americans: A demographic portrait. New York, NY: Russell Sage Foundation and Population Reference Bureau.

    Google Scholar 

  • Ying, Y. W. (1988). Depressive symptomatology among Chinese-Americans as measured by the CES-D. Journal of Clinical Psychology, 44, 739–746. doi:10.1002/1097-4679(198809)44:5<739:AID-JCLP2270440512>3.0.CO;2-0

    Article  PubMed  CAS  Google Scholar 

  • Zeng, Z., & Xie, Y. (2004). Asian-Americans’ earnings disadvantage reexamined: The role of place of education. American Journal of Sociology, 109, 1075–1108. doi:10.1086/381914

    Article  Google Scholar 

  • Zuckerman, M. (1991). Psychobiology of personality. Cambridge, England: Cambridge University Press. doi:10.1097/00004850-199100640-00009

    Google Scholar 

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Acknowledgments

The National Latino and Asian American Study (NLAAS) was supported by the National Institute of Mental Health (grants U01 MH62209 and U01 MH62207).

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Authors and Affiliations

  1. Department of Sociology, Ball State University, Muncie, IN, 46037, USA

    Fang Gong & Jun Xu

  2. School of Social Work, University of Washington, Seattle, WA, USA

    David T. Takeuchi

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  1. Fang Gong
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  2. Jun Xu
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  3. David T. Takeuchi
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Correspondence to Fang Gong.

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Gong, F., Xu, J. & Takeuchi, D.T. Beyond conventional socioeconomic status: examining subjective and objective social status with self-reported health among Asian immigrants. J Behav Med 35, 407–419 (2012). https://doi.org/10.1007/s10865-011-9367-z

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  • DOI: https://doi.org/10.1007/s10865-011-9367-z

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