Abstract
Objective: It has been suggested that subjective social status may be a better, more powerful health correlate than traditional socioeconomic status indicators (e.g., education, income). The aim of this study is to determine how subjective social status relates to an early health risk indicator, specifically, basal cortisol dysfunctions. Additionally, very few studies have examined the stability of SSS measures over time. The current study will examine the stability of the original measures, US and community, with newly added and more narrowly defined measures, neighborhood, friends, and family, and their association to hypothalamic–pituitary–adrenal axis indicator, cortisol awakening response, diurnal cortisol, and total daily cortisol output.
Methods: Sixty women (mean age: 60.13, SD = 6.45 years) self-reported SSS ratings using the 10-rung MacArthur ladders (community and US) and narrowly defined ladders (neighborhood, friends, and family) before and after a 12-week intervention. Two sets of five cortisol samples immediately upon waking up, 30, 45, and 60 minutes after waking up, and at bedtime were collected before and after the intervention as well.
Results: The intervention was successful as daily step count increased across the intervention (F(1,59) = 74.03; p < .001). After controlling for SES measures (years of education), the effect of time was no longer significant (F(1,58) = 0.30, p = .58), but the ladders remained significantly different from each other (F (2.69,156.22) = 3.81, p = .014). The US ladder was significantly correlated with the AUCG (r = -.27, p = .04), while the community ladder was significantly correlated with diurnal cortisol slope (r = -.28, p = .03)
Conclusions: The study emphasizes the importance of including both distal and proximal groups referenced groups when assessing perceived social status (US, community, neighborhood, friends, and family). While the US measure is able to capture stables influences of health, other ladders can provide health relevant information that is related to perceived status in different social circles.