Subjective Social Status And Health-Related Quality Of Life-A Cross-Lagged Panel Analysis

Objective: Subjective social status (SSS) refers to individuals' perceived position in the social hierarchy. Prior research suggests that SSS relates to health above and beyond objective socioeconomic status (OSS) such as income, occupation, or education. Most findings in this field, however, stem from cross-sectional studies or longitudinal studies with one-time measurements of SSS only. The aim of this study was to examine reciprocal longitudinal associations of both national SSS (i.e., comparison with people in one's country) and local SSS (i.e., comparison with people in one's social environment) with health-related quality of life. Method: A two-wave cross-lagged panel design with a 2-year follow-up was used to analyze data for national SSS, local SSS, physical and mental health-related quality of life (PHQL and MHQL), as well as OSS from initially 2,156 individuals who participated in the German Socioeconomic Panel Study-Innovation Sample (SOEP-IS). Results: Local and national SSS at baseline predicted PHQL at follow up and partially mediated associations between OSS and PHQL. Local SSS (but not national SSS) also predicted MHQL at follow-up but this association was only marginally significant after inclusion of OSS in the model. Regarding a reverse health-to-SSS pathway, PHQL (but not MHQL) at baseline predicted local and national SSS at follow-up and these associations were partially mediated by income. Conclusion: This study extends cross-sectional observations by confirming that both local and national SSS have unique longitudinal associations with health and provides novel insights into longitudinal pathways linking SSS, OSS, and health.