Subjective social status and its associations with social vulnerabilities and health

Abstract

BACKGROUND: Subjective social status (SSS) is the perception of where one stands in a social hierarchy, distinct from one’s actual, objective position in this hierarchy. SSS may influence health through behavioral and psychosocial mechanisms. METHODS: We conducted three sub-studies to examine whether SSS affects risk of and outcomes in chronic disease, and to explore the role of health care access and experience of social vulnerabilities in the SSS-health pathway. RESULTS: We found that low SSS is associated with increased risk of 1) cardiovascular disease; 2) hospital readmissions and barriers to health care access; and 3) social vulnerabilities that affect health care access. Having high perceived status in the community appears to mitigate the experience of social vulnerabilities through the ability to mobilize social supports. CONCLUSION: Subjective social status has important associations with health and clinical outcomes. These findings have implications to the development of interventions that aim to reduce disparities.