Relationship Between Subjective Social Status and Measures of Health in Older Taiwanese Persons

doi:10.1111/j.1532-5415.2005.53169.x

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Wiley InterScience

Journal of the American Geriatrics Society

Volume 53 Issue 3, Pages 483 - 488

Published Online: 24 Feb 2005

Journal compilation 2010 The American Geriatrics Society/Wiley Periodicals, Inc.

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Relationship Between Subjective Social Status and Measures of Health in Older Taiwanese Persons

Peifeng Hu, MD, PhD ^* , Nancy E. Adler, PhD ^† , Noreen Goldman, PhD ^‡ , Maxine Weinstein, PhD ^§ , and Teresa E. Seeman, PhD ^*

From the ^*Multicampus Program in Geriatric Medicine and Gerontology, University of California at Los Angeles School of Medicine, Los Angeles, California; ^†Health Psychology Program, University of California at San Francisco, San Francisco, California; ^‡Office of Population Research, Princeton University, Princeton, New Jersey; and ^§Center for Population and Health, Graduate School of Arts and Sciences, Georgetown University, Washington, DC.

Correspondence to Peifeng Hu, MD, PhD, Multicampus Program in Geriatric Medicine and Gerontology, UCLA School of Medicine, 10945 Le Conte Avenue, Suite 2339, Los Angeles, CA 90095. E-mail:phu@mednet.ucla.edu

This project was supported by funding from the National Institute on Aging (Grant AG16661 and AG16790), Pfizer/American Geriatrics Society Foundation for Health in Aging Junior Faculty Scholar Program for Research on Health Outcomes, the UCLA Claude Pepper Older American Independence Center (P06 AG10415-11), and the MacArthur Research Network on SES and Health through grants from the John D. and Catherine T. MacArthur Foundation.

KEYWORDS

subjective SES • self-rated health • functional status • aging

ABSTRACT

Objectives: To compare the association between subjective ladder ranking and health measures with the association between objective indices and health measures in older Taiwanese men and women.

Design: Cross-sectional study.

Setting: A population-representative sample of elderly and nearly elderly men and women in Taiwan.

Participants: The study included 991 participants from the Social Environment and Biomarkers of Aging Study in Taiwan.

Measurements: The information collected included demographic characteristics; subjective ladder score of SES; objective measures of SES, including education, income, and occupation; health behaviors; health-related variables such as self-rated health, basic activity of daily living difficulties, instrumental activity of daily living (IADL) difficulties, and physical activity difficulties; and depression score.

Results: Low ladder score was associated with poorer self-rated health and more reported IADL and physical activity difficulties, even after adjustment for objective measures of SES and other covariates. The multiply adjusted odds ratio for a one-quartile difference in ladder score and worse self-rated health was 1.19 (95% confidence interval=1.06–1.33). The associations between subjective ladder ranking and health status were generally stronger in those who had 6 years or less of education than in those who received more education.

Conclusion: A simple subjective assessment of one's ranking on the social hierarchy was associated with self-rated health and physical functional status in an older ethnic Chinese population. The associations were independent of the effects of traditional objective measures of SES, such as education, income, and occupation.

DIGITAL OBJECT IDENTIFIER (DOI)

10.1111/j.1532-5415.2005.53169.x About DOI