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Subjective social status and health: A meta-analysis of community and society ladders

Zell E, Strickhouser JE, Krizan Z

Health psychology : official journal of the Division of Health Psychology, American Psychological Association, 2018

142,836 participants

Abstract

OBJECTIVE: To derive a robust estimate of the relation between health and subjective status in society versus subjective status in one's community, and to identify moderators of these effects, using meta-analysis.

METHOD: Thirty-eight independent studies, which included both subjective status ladders and collectively provided data from 142,836 participants, met criteria for inclusion. Information on sample characteristics (e.g., age, gender, continent), methodological factors (e.g., scale type, methodological quality), and statistical factors (e.g., model type, inclusion of objective socioeconomic status covariates) were extracted from each study. Random-effects meta-analysis was used to aggregate data across studies.

RESULTS: Both the community ladder and the society ladder yielded small but statistically significant associations with health behavior (r = .06 and r = .06), mental health (r = .13 and r = .11), physical health (r = .05 and r = .04), and self-rated health (r = .08 and r = .09) that were comparable in size and were qualified in a similar way by the type of health outcome, sample age, continent, and methodological quality. Additionally, community and society ladders remained significantly associated with health both when considered simultaneously and following the inclusion of objective socioeconomic status covariates.

CONCLUSIONS: This meta-analysis is the first to establish a unique association of the community ladder with health. It also supports social…

How strong is the evidence?

Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 142,836 participants or records.

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