Self-perceived social status linked to CV health among Hispanic and Latino individuals
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Self-perceived social status among Hispanic and Latino individuals living in the U.S. was associated with good CV health as measured by the American Heart Association’s Life’s Simple 7 scores, researchers reported.
However, according to data published in the Journal of the American Heart Association, this relationship was only significant among Hispanic and Latino individuals who were either U.S.-born or foreign-born participants who lived in the country for at least 10 years.
“People who have migrated to the U.S. often experience a change in subjective social status that could affect their cardiovascular health. For example, a person who was previously a teacher or lawyer in a Latin American country such as Colombia or Mexico may find their employment prospects constrained in the U.S. by language issues and incompatible professional credentials. For them, the migration experience coincides with a diminished social status by objective standards; that is, they might only be able to find employment in the low-wage service sector such as driving a taxicab. This outcome affects the person’s sense of social standing,” Lissette M. Piedra, PhD, MSW, associate professor in the School of Social Work at the University of Illinois at Urbana-Champaign, said in a press release. “However, consider the person who is from a rural Latin American community with serious labor shortages and extremely low wages. In the U.S., they may continue to occupy low-income jobs relative to the general population, yet the actual pay for the same job in the U.S. may be many-fold greater than what was possible in their country of origin. Even though there hasn’t been a change in education level or skills, the increased income may result in a completely different self-perceived social standing.”
Researchers utilized baseline Hispanic Community Health Study/Study of Latinos (HCHS/SOL) data on 15,374 adults (mean age, 41 years; 52% women; 50% with health insurance) collected from 2008 to 2011.
HCHS/SOL participants responded to the MacArthur Scale of Subjective Social Status, which captures self-perceived socioeconomic standing by pictorially depicting a 10-rung “social ladder.”
People at the top of the ladder are described as being the best off (the most money, the most education and the most respected jobs) and those on the lower rungs are the worst off (have the least money, least education and the least respected or no jobs). Participants verbally indicated on which rung, 1 to 10, was their self-perceived social standing. Researchers utilized these responses to assess the relationship between perceived-social standing and CV health as evaluated by the presence of the AHA’s Life’s Simple 7.
Self-perceived social standing and CV health
According to the study, the average level of self-perceived social standing was 4.4. Approximately 60% of the cohort reported having a high school education or lower; 42% lived in households with annual income of less than $20,000; and 49% were not employed.
For the entire cohort, the prevalence of each of the AHA’s Life’s Simple 7 were as follows: 1.6% for healthy eating, 23.3% for BMI, 49.8% for BP, 53.5% for cholesterol, 66.7% for fasting glucose, 66.8% for physical activity and 76.3% for smoking.
Fewer than half of participants had four or more ideal scores across all metrics.
Researchers reported that each rung higher of self-perceived social standing was associated with increased CV health score as well as higher levels of ideal smoking, BMI, physical activity and fasting blood glucose (P < .01).
According to the study, self-perceived social standing was linked to increases in CV health score (beta = 0.04; 95% CI, 0.01-0.06; P < .01) and odds of having an ideal BMI (OR = 1.04; 95% CI, 1.01-1.07; P < .05), ideal physical activity (OR = 1.03; 95% CI, 1-1.07; P < .05) and ideal fasting glucose (OR = 1.04; 95% CI, 1.01-1.07; P < .05).
After further adjustment for mental and physical health, the association between self-perceived social standing and CV health became nonsignificant; however, higher self-perceived standing remained associated with ideal BMI (OR = 1.04; 95% CI, 1-1.07; P < .05) and fasting glucose (OR = 1.03; 95% CI, 1-1.07; P < .05).
US-born vs. foreign-born participants
Researchers noted that the association between self-perceived social standing and CV health was only significant for U.S.-born participants and foreign-born participants who lived in the country for 10 years or more (P < .05).
“Our subjective experience influences how we take care of ourselves and how we interact with others. Over the life course, these every day actions can have a significant impact on our health,” Piedra said in the release. “The clinical implication is that a perceived sense of high social status could be protective, especially at the population level, where small differences that compound over time matter.”
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