Perceived social position and health in older adults in Taiwan

doi:10.1016/j.socscimed.2007.10.004

Social Science & Medicine

Volume 66, Issue 3, February 2008, Pages 536-544

https://doi.org/10.1016/j.socscimed.2007.10.004 Get rights and content

Abstract

We examined whether perceived social position predicted mental and physical health outcomes (depressive symptoms, cognitive impairment, mobility restrictions, and self-assessed health) in a prospective study based on a nationally representative sample of older persons in Taiwan. Cross-sectional and longitudinal models were used to demonstrate the relationship between perceived social position and health, as reported by participants in the Social Environment and Biomarkers of Aging Study in Taiwan (SEBAS). Lower perceived social position predicted declining health beyond what was accounted for by objective indicators of socioeconomic position. As predicted, the effect was substantially reduced for all health outcomes in the presence of controls for baseline health. After including these controls, perceived social position was significantly related only to depressive symptoms. The findings suggest that the strength of the association between perceived social position and health may have been overstated in cross-sectional studies.

Section snippets

Participants

The sample includes participants in the longitudinal Survey of Health and Living Status of the Near-elderly and Elderly in Taiwan. The first wave of data collection began in 1989 with a nationally representative sample of 4049 persons aged 60 and older and an additional national sample of 2642 near-elderly persons aged 50–66 years in 1996. Respondents have been re-interviewed at approximate 3-year intervals since the initial interview date, including data collection in 1999 and 2003. In 2000, a

Results

The sociodemographic characteristics and health status of the study population are shown in Table 1. The participants ranged in age from 54 to 91 years (M=67.7; S.D.=8.1). The sample was 57% male because of the selective migration of men from mainland China in 1949. The average perceived social position score was 3.8 (S.D.=1.9) and mean education level was 5.3 years (S.D.=4.7). Only 27% of the sample had more than 6 years of education. There was substantial change in all of the health outcomes

Discussion

Our primary purpose was to extend previous work examining the association between perceived social position and health by including extensive baseline controls for health in longitudinal models using a nationally representative sample of older adults in Taiwan. Use of the Taiwan data also permits us to evaluate the strength of this relationship for a sample that is older and less educated than those in previous studies of perceived social position and health (Adler et al., 2000; Dunn et al.,

Acknowledgments

Support for this project came from the Demography and Epidemiology Unit of the Behavioral and Social Research Program of the National Institute of Aging (Grant R01AG16790) and the National Institute of Child Health and Human Development (Grant 5P30HD32030). The authors thank Dana Glei for helpful comments on the manuscript.

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Perceived social position and health in older adults in Taiwan

Abstract

Section snippets

Participants

Results

Discussion

Acknowledgments

Lancet

Social Science & Medicine

Social Science & Medicine

Social Science & Medicine

Experimental Gerontology

Social Science & Medicine

Social Science & Medicine

Socioeconomic status and health: The challenge of the gradient

American Psychologist

Relationship of subjective and objective social status with psychological and physiological functioning: Preliminary data in healthy, white women

Health Psychology

Cross-validation of a short form of the CES-D in Chinese elderly

International Journal of Geriatric Psychiatry

Changes in subjective and objective measures of economic well-being and their interrelationship among the elderly in Singapore and Taiwan

Social Indicators Research

Social ties and perceived support: Two dimensions of social relationships and health among the elderly in Taiwan

Journal of Aging and Health

Measuring subjective social status: A case study of older Taiwanese

Journal of Cross-Cultural Gerontology

Adolescents’ perceptions of social status: Development and evaluation of a new indicator

Pediatrics

Measurement properties of the Center for Epidemiological Studies Depression scale (CES-D) in older populations

Psychological Assessment

Continuity and change in the social stratification of aging and health over the life course: Evidence from a nationally representative study from 1986 to 2001/2002 (Americans’ Changing Lives Study)

Journals of Gerontology: Social Sciences