Subjective social status in association with various health and socioeconomic indicators in Tehran

Abstract

Aim: Socioeconomic status (SES) is one of the most important determinants of health. Subjective social status (SSS) is a popular SES indicator. The objective of this study is to compare the associations between health and various SES indicators in order to examine whether SSS is a proper SES indicator. Subject and methods: In this 2013 cross-sectional study, 1,995 Tehrani residents were selected through multi-stage random sampling. The questionnaires included items on subjective and objective SES, self-rated health (SRH) and objective health status. The crude and adjusted associations between health and SES indicators were assessed using bivariate and multiple logistic regressions. Results: The crude associations between SSS and all assessed health outcomes were significant. After adjustment of the wealth index, consumption, education and occupation, the associations between SSS and SRH (OR = 0.69, CI 95 : 0.55�0.86) and having cardiovascular (OR = 0.73, CI 95 : 0.58�0.92), musculoskeletal (OR = 0.81, CI 95 : 0.70�0.94), asthma and other respiratory diseases (OR = 0.71, CI 95 : 0.54�0.92) still remained significant. The adjusted associations between SSS and having hypertension and diabetes were not significant. SSS had a stronger correlation with the wealth index (Spearman r = 0.42) compared to other SES indicators. Conclusion: SSS showed a significant association with most of the health outcomes, independent of other SES indicators; therefore, it can be used in health research, though it is not an exact alternative for other objective SES indicators. © 2016, Springer-Verlag Berlin Heidelberg