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Socio-economic Status and Self-Rated Health Among Older Canadians

Published online by Cambridge University Press:  29 November 2010

John Cairney
Affiliation:
Brock University

Abstract

Although previous research has examined the various correlates of self-rated health, little attention has been paid to how position in the social structure influences this important measure of health. Drawing upon the social structure and personality perspective, I examine whether the relationship between socio-economic status (income adequacy and education) and self-rated health is mediated by financial stress, self-esteem, mastery, social support, smoking, alcohol consumption and physical activity, using data from the 1994 National Population Health Survey. Results show that almost one-third of the relationship can be explained by the mediating effect of these variables. Income adequacy and education, however, remain significantly related to self-rated health net of these variables. Further research with a broader array of variables related to social position is required to specify the mechanisms connecting socio-economic status and perceived health.

Résumé

Bien que des recherches aient déjà examiné les différents facteurs de l'auto-évaluation de la santé, on a accordé peu d'attention à l'influence de la position sociale sur cette importante mesure de la santé. À même la structure sociale et la perspective de la personnalité, on a voulu savoir si la relation entre la situation socio-économique (revenu adéquat et instruction) et l'auto-évaluation de la santé était touchée par le stress financier, l'estime et la maîtrise de soi, l'appui social, le tabac, l'alcool et l'activité physique; on s'est servi de données de l'Enquête nationale sur la santé de la population de 1994. Les résultats indiquent qu'environ le tiers de la relation s'explique par l'effet de ces variables. Par contre, le revenu adéquat et l'instruction demeurent étroitement reliés à l'auto-évaluation de la santé en excluant les autres variables. Il faudra pousser la recherche en augmentant le nombre des variables reliées à la position sociale si l'on veut préciser les mécanismes qui relient la situation socio-économique et la perception du degré de santé.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2000

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References

Aneshensel, C.S., Rutter, C.M., & Lachenbruch, P.A. (1991). Social structure, stress and mental health. American Sociological Review, 56, 166178.CrossRefGoogle Scholar
Arber, S., & Ginn, J. (1993). Gender and inequalities in health in later life. Social Science and Medicine, 36(1), 3346.CrossRefGoogle ScholarPubMed
Baird, P.A. (1994). The role of genetics in population health. In Evans, R.G., Barer, M.L., & Marmor, T.R. (Eds.), Why are some people healthy and others not? The determinants of health of populations? (pp. 161188). New York: de Gruyter.Google Scholar
Beaglehole, R. (1990). International trends in coronary heart disease mortality, morbidity and risk factors. Epidemiologic Reviews, 12, 116.CrossRefGoogle ScholarPubMed
Blane, D., Davey Smith, G., & Bartley, M. (1993). Social selection: what does it contribute to social class differences in health? Sociology of Health and Illness, 15, 115.CrossRefGoogle Scholar
Blaxter, M. (1990). Health and lifestyles. London: Routledge.CrossRefGoogle Scholar
Cairney, J., & Arnold, R. (1996). Social class, health and aging: socioeconomic determinants of self-reported morbidity among the non-institutionalized elderly in Canada. Canadian Journal of Public Health, 87(3), 199203.Google Scholar
Cassel, J. (1976). The contribution of the social environment to host resistance. American Journal of Epidemiology, 104, 107123.CrossRefGoogle ScholarPubMed
Chipperfield, J.G. (1993). Incongruence between health perceptions and health problems: implications for survival among seniors. Journal of Aging and Health, 5, 475–196.CrossRefGoogle Scholar
Darrow, S.L., Russell, M., Copper, M.L., Mudar, P., & Frone, M.R. (1992). Sociodemographic correlates of alcohol among African-American and white women. Women and Health, 18, 3551.CrossRefGoogle ScholarPubMed
Doornbos, G., & Kromhout, D. (1990). Educational level and mortality in a 32-year follow-up study of 18-year-old men in The Netherlands. International Journal of Epidemiology, 19(2), 374379.CrossRefGoogle Scholar
Evans, R.G., & Stoddart, G.L. (1994). Producing health, consuming health care. In Evans, R.G., Barer, M.L., L., M., & Marmor, T.R. (Eds.), Why are some people healthy and others not? The determinants of health of populations? (pp. 161188). New York: de Gruyter.CrossRefGoogle Scholar
Feinstein, J.S. (1993). The relationship between socioeconomic status and health: a review of the literature. Milbank Quarterly, 71(2), 279322.CrossRefGoogle Scholar
Ferraro, K.F. (1980). Self-ratings of health among the old and old-old. Journal of Health and Social Behaviour, 21, 377383.CrossRefGoogle ScholarPubMed
Fox, A.J., Goldblatt, P.O., & Jones, D.R. (1985). Social class and mortality differentials: artefact, selection, or life circumstances. American Journal of Epidemiology, 39, 18.Google ScholarPubMed
Gaziano, J.M., Buring, J.E., Breslow, J.L., Goldhaber, S.Z., Rosner, B., Van Denburgh, M.V., Willett, W., & Hennekens, C.H. (1993). Moderate alcohol intake, increased levels of high-density lipoprotein and its subfractions, and decreased risk of myocardial infarction. The New England Journal of Medicine, 329(25), 18291834.CrossRefGoogle ScholarPubMed
Geacs, V. (1989). The social psychology of self-efficacy. Annual Review of Sociology, 15, 291316.CrossRefGoogle Scholar
George, L.K. (1992). Economic status and subjective well-being: a review of the literature and an agenda for further research. In Culter, N.E., Gregg, D.W., & Lawton, M.P. (Eds.), Aging, money, and life satisfaction (pp. 6999). New York: Springer.Google Scholar
George, L.K. (1996). Missing links: the case for a social psychology of the life course. The Gerontologist, 36(2), 248255.CrossRefGoogle ScholarPubMed
Grembowski, D., Patrick, D., Diehr, P., et al. (1993). Self-efficacy and health behaviour among older adults. Journal of Health and Social Behaviour, 34, 89104.CrossRefGoogle ScholarPubMed
Hay, D. (1988). Socioeconomic status and health: a study of males in the Canadian Health Survey. Social Science and Medicine, 27(12), 13171325.CrossRefGoogle Scholar
Hirdes, J.P., Brown, S.K., Forbes, W.F., Vigoda, D., & Crawford, L. (1986). The association between self-reported income and perceived health based on the Ontario Longitudinal Study of Aging. Canadian Journal on Aging, 5(3), 189204.CrossRefGoogle Scholar
House, J.S. (1981). Work stress and social support. Reading, MA: Addison-Wesley.Google Scholar
House, J.S., Kessler, R.C., Herzog, A.R., Mero, R.P., Kinney, A.M., & Breslow, M.J. (1990). Age, socioeconomic status, and health. Milbank Quarterly, 68(3), 383411.CrossRefGoogle ScholarPubMed
House, J.S., Landis, K.K., & Umberson, D. (1988). Social relationships and health. Science, 241, S40–S45.CrossRefGoogle ScholarPubMed
House, J.S., Kessler, R.C., Herzog, A.R., Mero, R.P., Kinney, A.M., & Breslow, M.J. (1992). Social stratification, age, and health. In Schaie, K.W., W, K., & House, J.S. (Eds.), Aging, health behaviors and health outcomes (pp. 132). Hillsdale, NJ: Erlbaum.Google Scholar
House, J.S., Lepkowski, J.M., Kinney, A.M., Mero, R.P., Kessler, R.C., & Herzog, A.R. (1994). The social stratification of aging and health. Journal of Health and Social Behaviour, 35, 213234.CrossRefGoogle ScholarPubMed
Hulka, B.S., & Wheat, J.R. (1985). Patterns of utilization: the patient perspective. Medical Care, 23, 438460.CrossRefGoogle ScholarPubMed
Idler, E. (1993). Age differences in self-assessments of health: age changes, cohort differences, or survivorship? Journal of Gerontology: Social Sciences, 48, S289–S300.CrossRefGoogle ScholarPubMed
Idler, E., & Angel, R.J. (1990). Age, chronic pain, and subjective assessments of Health. Advances in Medical Sociology, 1, 131152.Google Scholar
Idler, E., & Benyamini, Y. (1997). Self-rated health and mortality: A review of twenty-seven community studies. Journal of Health and Social Behaviour, 38, 2137.CrossRefGoogle ScholarPubMed
Johnson, R.J., & Wolinsky, F.D. (1993). The structure of health status among older adults: disease, disability, functional limitation, and perceived health. Journal of Health and Social Behaviour, 34, 105121.CrossRefGoogle ScholarPubMed
Johnson, T.P., Stallones, L., Garrity, T., & Marx, M.B. (1990). Components of self-rated health among adults: analysis of multiple data sources. International Quarterly Journal of Community Health Education, 11, 2941.CrossRefGoogle ScholarPubMed
Kirk, R.E. (1968). Experimental design: Procedures for the behavioral sciences. Belmont, CA: Brooks/Cole.Google Scholar
Kitagawa, E.M., & Hauser, P.M. (1973). Differential mortality in the United States: A study in socioeconomic epidemiology. Cambridge, MA: Harvard University Press.CrossRefGoogle Scholar
Kutner, N.G. (1987). Social ties, social support, and perceived health status among chronically disabled people. Social Science and Medicine, 25, 2934.CrossRefGoogle ScholarPubMed
Liang, J. (1986). Self-reported physical health among aged adults. Journal of Gerontology, 41, 248260.CrossRefGoogle ScholarPubMed
Link, B.G., & Phelan, J. (1995). Social conditions as fundamental causes of disease. Journal of Health and Social Behaviour, (suppl.), 8094.CrossRefGoogle ScholarPubMed
Markides, K.S., & Lee, D.J. (1990). Predictors of well-being and functioning in older Mexican Americans and Anglos. Journal of Gerontology: Social Sciences, 45, S69–S73.CrossRefGoogle ScholarPubMed
Marmot, M.G., Shipley, M.J., & Rose, G. (1984). Inequalities in death — specific explanations of a general pattern. Lancet, 1(May), 10031006.CrossRefGoogle ScholarPubMed
Marshall, V.W. (1995). Rethinking retirement: issues for the twenty-first century. In Gee, E.M. & Gutman, G.M. (Eds.), Rethinking retirement (pp. 5168). Burnaby: Simon Fraser University Press.Google Scholar
Mossey, J.A., & Shapiro, E. (1982). Self-rated health: A predictor of mortality among the elderly. American Journal of Public Health, 72(8), 800808.CrossRefGoogle Scholar
Musiek, M.A. (1996). Religion and subjective health among black and white elders. Journal of Health and Social Behavior, 37, 221237.CrossRefGoogle Scholar
Myers, J.L. (1979). Fundamentals of experimental design (3rd ed.). Boston: Allyn and Bacon.Google Scholar
Pearlin, L.I. (1989). The sociological study of stress. Journal of Health and Social Behavior, 30, 241256.CrossRefGoogle ScholarPubMed
Pearlin, L.I., & Schooler, C. (1978). The structure of coping. Journal of Health and Social Behavior, 49, 221.CrossRefGoogle Scholar
Pearlin, L., & Skaff, M.M. (1996). Stress and the life course: A paradigmatic alliance. The Gerontologist, 36(2), 239247.CrossRefGoogle ScholarPubMed
Power, C.O., Manor, J., Fox, A.J., & Folgelman, K. (1990). Health in childhood and social inequalities in young adults. Journal of the Royal Statistical Society, 153, 1728.CrossRefGoogle Scholar
Radowski, W., Fleishman, J.A., Mor, V., & Bryant, S.A. (1993). Self-assessments of health and mortality among older persons. Research on Aging, 15, 92116.CrossRefGoogle Scholar
Robert, S., & House, J.S. (1996). Socioeconomic differentials in health by age and alternative indicators of SES. Journal of Aging and Health, 8(3), 359388.CrossRefGoogle ScholarPubMed
Rosenberg, M. (1979). Conceiving of self. New York: Basic Books.Google Scholar
Ross, C.E., & Bird, C.E. (1994). Sex stratification and lifestyle: Consequences for men's and women's perceived health. Journal of Health and Social Behavior, 35(2), 161178.CrossRefGoogle ScholarPubMed
Ross, C.E., & Van Willigen, M. (1997). Education and the subjective quality of life. Journal of Health and Social Behavior, 38, 275297.CrossRefGoogle ScholarPubMed
Ross, C.E., & Wu, C. (1996). Education, age and the cumulative advantage in Health. Journal of Health and Social Behavior, 37, 104120.CrossRefGoogle ScholarPubMed
Stampfer, M.J., Colditz, G.A., Willett, W.C., Speizer, F.E., & Hennekens, C.H. (1988). A prospective study of moderate alcohol consumption and the risk of coronary disease and stroke in women. New England Journal of Medicine, 319(5), 267273.CrossRefGoogle ScholarPubMed
Statistics Canada. (1980). Income distributions by size in Canada. Ottawa: Ministry of Supply and Services.Google Scholar
Statistics Canada. (1983). Rebasing low cut-offs to 1978. Technical Reference Paper (Cat. NO. 8–3302–519.) Ottawa: Minister of Supply and Services.Google Scholar
Su, Y.P., & Ferraro, K.F. (1997). Social relations and health assessments among older people: do the effects of integration and social contributions vary cross-culturally? Journal of Gerontology, 52(1), S27–S36.CrossRefGoogle Scholar
Thoits, P.A. (1983). Multiple identities: Examining gender and marital status differences in distress. American Sociological Review, 48, 174187.CrossRefGoogle Scholar
Thoits, P.A. (1995). Social psychology: The interplay between sociology and psychology. Social Forces, 73(4), 12311243.CrossRefGoogle Scholar
Thorslund, M., & Lundberg, O. (1994). Health and inequalities among the oldest old. Journal of Aging and Health, 6(1), 5169.CrossRefGoogle ScholarPubMed
Townsend, P., & Davidson, N. (1982). Inequalities in health. Harmondsworth: Penguin Books.Google Scholar
Townsend, P., Phillimore, P., & Beattie, A. (1988). Health and deprivation: inequality and the north. London: Croom Helm.Google Scholar
Turner, R.J., & Roszell, P. (1994). Psychosocial resources and the stress process. In Avison, W.R. & Gotlib, I.H. (Eds.), Stress and mental health: Contemporary issues and prospects for the future. New York: Plenum Press.Google Scholar
Victor, C.R. (1989). Inequalities in health in old age. Age and Ageing, 18, 387391.CrossRefGoogle Scholar
Wilkinson, R.G. (1986). Income and mortality. In Wilkinson, R.G. (Ed.), Class and health: research and longitudinal data. London: Tavistock.Google Scholar
Williams, D.R. (1990). Socioeconomic differentials in health: a review and re-direction. Social Psychology Quarterly, 53, 8199.CrossRefGoogle Scholar
Wolinsky, F.D., & Arnold, C.L. (1988). A different perspective on health and health services utilization. Annual Review of Gerontology and Geriatrics, 8, 71101.CrossRefGoogle ScholarPubMed
Wolinsky, F.D., & Johnson, R.J. (1992). Perceived health status and mortality among older men and women. Journals of Gerontology, 47, S304–S312.CrossRefGoogle ScholarPubMed