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Social status: a state of mind?
Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science.
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis is concerned with social stratification of psychosocial factors and social position measurement in population samples collected in mid-Sweden 2000-2006. Traditional resource-based measures of social position (occupation, education) and so far less explored prestige-based measures (subjective status, status incongruence) are tested with respect to their associations with psychosocial factors, emotions, and selfrated health. Three papers in this thesis are based on data from the Life Conditions, Stress, and Health (LSH) study, using a randomly selected population sample. Data for the fourth paper is a regional sample drawn from the health-related survey “Liv och Hälsa 2000”. Statistical methods range from correlation analysis to logistic regression and repeated measures analyses.

Results from studies I and IV show that psychosocial factors are unequally distributed within the population in a linear manner, so that the lower the socioeconomic position (SEP), the more unfavourable levels. This is independent of whether we study this in a highly unequal setting such as Russia, or in a more egalitarian society such as Sweden. The stability of psychometric instruments over two years tend to be lower for all instruments among low SEP groups, and differ significantly for self-esteem and perceived control among groups with high and low education, and for cynicism among groups with high and low occupational status. Results from studies II and III point to the relevance of individuals’ own thoughts about themselves, and the potential impact on the self by normative judgements of social position in a certain hierarchical setting. In paper II, the prestige-based measure of subjective status was influenced by resource-based measures, such as self-rated economy and education, but also by life satisfaction and psychosocial factors. The importance of self-evaluation was especially obvious from the study on status incongruence (study III) where the traditionally protective effecs of a high education seem to disappear when combined with a lowstatus occupation. Shaming experiences may play an important role here for our understanding of self-perception.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press , 2008. , 96 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1083
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:liu:diva-15552ISBN: 978-91-7393-781-8 (print)OAI: oai:DiVA.org:liu-15552DiVA: diva2:126419
Public defence
2008-12-12, Berzeliussalen, Universitetssjukhuset, Campus US, Linköpings universitet, Linköping, 13:00 (English)
Opponent
Supervisors
Available from: 2008-11-17 Created: 2008-11-17 Last updated: 2009-05-06Bibliographically approved
List of papers
1. Adverse health effects of low levels of perceived control in Swedish and Russian community samples
Open this publication in new window or tab >>Adverse health effects of low levels of perceived control in Swedish and Russian community samples
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2007 (English)In: BMC Public Health, ISSN 1471-2458, Vol. 7, no 314Article in journal (Refereed) Published
Abstract [en]

Background: This cross-sectional study of two middle-aged community samples from Sweden and Russia examined the distribution of perceived control scores in the two populations, investigated differences in individual control items between the populations, and assessed the association between perceived control and self-rated health.

Methods: The samples consisted of men and women aged 45–69 years, randomly selected from national and local population registers in southeast Sweden (n = 1007) and in Novosibirsk, Russia (n = 9231). Data were collected by structured questionnaires and clinical measures at a visit to a clinic. The questionnaire covered socioeconomic and lifestyle factors, societal circumstances, and psychosocial measures. Self-rated health was assessed by standard single question with five possible answers, with a cut-off point at the top two alternatives.

Results: 32.2 % of Swedish men and women reported good health, compared to 10.3 % of Russian men and women. Levels of perceived control were also significantly lower in Russia than in Sweden and varied by socio-demographic parameters in both populations. Sub-item analysis of the control questionnaire revealed substantial differences between the populations both in the perception of control over life and over health. Logistic regression analysis revealed that the odds ratios (OR) of poor self-rated health were significantly increased in men and women with low perceived control in both countries (OR between 2.61 and 4.26).

Conclusions: Although the cross-sectional design does not allow causal inference, these results support the view that perceived control influences health, and that it may mediate the link between socioeconomic hardship and health.

National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-15548 (URN)10.1186/1471-2458-7-314 (DOI)
Note
Original Publication: Johanna Lundberg, Martin Bobak, Sofia Malyutina, Margareta Kristenson and Hynek Pikhart, Adverse health effects of low levels of perceived control in Swedish and Russian community samples, 2007, BMC Public Health, (7), 314. http://dx.doi.org/10.1186/1471-2458-7-314 Licensee: BioMed Central http://www.biomedcentral.com/ Available from: 2008-12-21 Created: 2008-11-17 Last updated: 2009-05-06Bibliographically approved
2. Is Subjective Status Influenced by Psychosocial Factors?
Open this publication in new window or tab >>Is Subjective Status Influenced by Psychosocial Factors?
2008 (English)In: Social Indicators Research, ISSN 0303-8300, Vol. 89, no 3, 375-390 p.Article in journal (Refereed) Published
Abstract [en]

Objective Associations between subjective status and health are still relatively unexplored. This study aimed at testing whether subjective status is uniquely confounded by psychosocial factors compared to objective status, and what factors that may predict subjective status. Design A cross-sectional analysis of a population-based, random sample of 795 middle-aged men and women from the southeast of Sweden. Questionnaires included subjective status, objective measures of socioeconomic status, life satisfaction, and a battery of psychosocial factors. Associations were controlled for effects of age and sex. Results Both subjective status and occupation were significantly associated with self-rated health also after control for psychosocial factors. Stepwise regression showed that subjective status was significantly influenced by self-rated economy, education, life satisfaction, self-esteem, trust, perceived control, and mastery. Conclusion The association between subjective status and self-rated health does not seem to be uniquely confounded by psychosocial factors. Both resource-based measures and psychological dimensions seem to influence subjective status ratings. Comparative studies are required to study whether predictors of subjective status vary between countries with different socio-political profiles.

Keyword
Subjective status, Social status, Socioeconomic status, Psychosocial factors, Life satisfaction, Self-anchored ladder, Self-perceived status, Self-rated health, Psychological resources, Psychological risk factors
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-15549 (URN)10.1007/s11205-008-9238-3 (DOI)
Note
The original publication is available at www.springerlink.com: Johanna Lundberg and Margareta Kristenson, Is Subjective Status Influenced by Psychosocial Factors?, 2008, Social Indicators Research, (89), 3, 375-390. http://dx.doi.org/10.1007/s11205-008-9238-3 Copyright: Springer Science Business Media http://www.springerlink.com/ Available from: 2008-12-17 Created: 2008-11-17 Last updated: 2009-02-17Bibliographically approved
3. Status incongruence revisited - associations with shame and mental well-being (GHQ)
Open this publication in new window or tab >>Status incongruence revisited - associations with shame and mental well-being (GHQ)
2009 (English)In: Sociology of Health and Illnes, ISSN 0141-9889, Vol. 31, no 4, 478-493 p.Article in journal (Refereed) Published
Abstract [en]

Study purpose: Status incongruence has been related to poor health and all-cause mortality, and could be a growing public health problem due to changes in the labour market in later decades. Shaming experiences have been suggested as playing a part in the aetiology. Our aim was to study the risk for shaming experiences, pessimism, anxiety, depressive feelings, and poor mental well-being (GHQ) with a special focus on shame, in four status categories: negatively and positively incongruent individuals, and low-status and high-status congruent individuals.

Method: Data comprised 14 854 working men and women from a regional sample of randomly selected respondents, 18-79 years. Logistic regression was used to study differences in risk for negative emotional outcomes. Results: The negative incongruent category persisted as the group most at risk for all negative emotional outcomes (OR 1.5-1.9; p<0.05-<0.001). When testing the risk for poor mental well-being among the status categories with and without shaming experiences, OR for all groups with shaming experiences were elevated. Among groups without shame, only the negative incongruent category remained at risk (OR 2.7; p<0.05) after adjustment.

Conclusion: Negative incongruent status is associated with adverse emotional outcomes, among them shame, which is a previously unappreciated aspect of status incongruence.

Keyword
social status • public health • status incongruence • GHQ • shame • mental wellbeing
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-15550 (URN)10.1111/j.1467-9566.2008.01148.x (DOI)
Note
This is the author version of the following article: Johanna Lundberg, Margareta Kristenson and Bengt Starrin, Status incongruence revisited: associations with shame and mental wellbeing, 2009, SOCIOLOGY OF HEALTH and ILLNESS, (31), 4, 478-493. which has been published in final form at: http://dx.doi.org/10.1111/j.1467-9566.2008.01148.x Copyright: Blackwell Publishing Ltd http://www.blackwellpublishing.com/ Available from: 2009-06-10 Created: 2008-11-17 Last updated: 2009-06-10Bibliographically approved
4. Does two-year stability for scale scores of psychosocial factors differ by socioeconomic position?
Open this publication in new window or tab >>Does two-year stability for scale scores of psychosocial factors differ by socioeconomic position?
2009 (English)In: Psychological Reports, ISSN 0033-2941, Vol. 105, no 3, 1009-1022 p.Article in journal (Refereed) Published
Abstract [en]

Previous longitudinal studies have demonstrated the importance of measuring stability of risk factors over time to correct for attenuation bias. The present aim was to assess the stability of scores for eight psychometric scales over a 2-yr. period and whether stability differed by socioeconomic position. Baseline data were collected during 2003–2004 from 1,007 men and women ages 45 to 69 years. Follow-up data were collected in 2006 from a total of 795 men and women. Analysis showed that stability over 2 yr. was moderate and tended to be lower in groups of low socioeconomic position. It is suggested that correction of attenuation bias is relevant in longitudinal studies for psychosocial factors, especially for groups of low socioeconomic position.

National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-15551 (URN)10.2466/PR0.105.F.1009-1022 (DOI)000274967100002 ()20229904 (PubMedID)
Note

Tidigare titel: Does 2-year stability of psychosocial factors differ by socioeconomic position? Original Publication: Johanna Lundberg, Nadine Karlsson and Margareta Kristenson, DOES TWO-YEAR STABILITY FOR SCALE SCORES OF PSYCHOSOCIAL FACTORS DIFFER BY SOCIOECONOMIC POSITION?, 2009, PSYCHOLOGICAL REPORTS, (105), 3, 1009-1022. http://dx.doi.org/10.2466/PR0.105.F.1009-1022 Copyright: Perceptual and Motor Skills http://www.ammonsscientific.com/ :Test-retest correlations of self-esteem, mastery, perceived control, sense of coherence, cynicism, hopelessness, vital exhaustion and depression in a middle-aged Swedish normal population

Available from: 2008-11-17 Created: 2008-11-17 Last updated: 2014-08-28Bibliographically approved

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