A Qualitative Descriptive Exploration of the Determinants of Subjective Social Status and the Pathways Through Which Subjective Social Status Shapes Health and Well-Being

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Abstract Introduction: Socioeconomic position (SEP) is traditionally measured using objective indicators (i.e. income, occupation, education) which may not capture the many pathways through which health inequities are generated. The MacArthur Scale of Subjective Social Status (SSS) is a subjective measure of SEP thought to reflect individuals’ perceptions of their social position, with high predictive utility for health. Despite the scale’s utility, there is limited research investigating the factors and reference groups that shape SSS. The mechanisms through which SSS shapes health also remain unclear, with literature suggesting both materialistic and psychosocial explanations. Objectives: Our study explored the factors and reference groups that working-aged adults consider when evaluating their SSS, and the pathways through which they perceive these factors shape their health and well-being. Methods: Our study employed qualitative descriptive methodology. We recruited 25 adults living in Alberta, aged 30-50, to participate in think-aloud style, semi-structured interviews. Data was analyzed using a semi-deductive, directed content analysis approach. Results: Four major themes summarized participants’ experiences: 1) The significance of reference groups in shaping SSS; 2) The big 3 determinants of SSS - Income, occupation, education; 3) Unique circumstances lead to unique conceptualizations of SSS; and 4) SSS affects mental wellbeing Conclusions: The primary determinants of SSS in working-aged adults in Canada are income, occupation and education. Additional determinants include gender, health and disability, and racial identity. Reference groups also significantly shaped SSS and differed across individuals. Study findings demonstrated that SSS shaped mental well-being through both materialist and psychosocial pathways, which suggests that researchers and policymakers must act upon structural SDH, especially income, education, and occupation, as well as upon the psychosocial stress resulting from social comparisons to reduce inequities in health.
Subjective social status, MacArthur scale, Qualitative research
Naser, A. (2024). A qualitative descriptive exploration of the determinants of subjective social status and the pathways through which subjective social status shapes health and well-being (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.