Introduction: Evidence suggests that subjective social status (SSS)—perceived status in the social hierarchy—may be more strongly associated with health than objective markers of social status (OSS), income and education. Compared to persons with high SSS, those with low SSS report poorer self-rated physical health and have higher rates of medical comorbidities. Little is known about the relationship between SSS and ideal cardiovascular health (CVH) profiles defined by the American Heart Association (AHA), particularly among diverse Hispanic/Latino adults.
Hypothesis: Higher SSS will be associated with more favorable CVH profiles.
Methods: We analyzed baseline HCHS/SOL data† on adults ages 18-74 in 2008-11 (N=15,440). SSS was assessed using the McArthur Scale, a 10-rung “social ladder” to specify social rank (scores range from 1-10; higher scores indicate higher SSS). CVH was defined based on levels of 7 metrics: diet, body mass index (BMI), physical activity, cholesterol, blood pressure, fasting glucose, and smoking status; levels of each metric were categorized as ideal, intermediate and poor using AHA criteria. A composite CVH score was calculated by summing across metrics (scores range from 0-14; higher scores indicate better CVH). Linear and logistic regressions were used to examine cross-sectional associations of SSS with CVH (overall and single metrics), after adjusting for OSS, demographics, Hispanic/Latino group, study center, marital status, insurance, prevalent coronary heart disease, and depressive symptoms (CESD).
Results: In multivariate-adjusted models, each one unit increase in SSS* was associated with a higher overall CVH score (β = 0.03, 95% CI 0.004, 0.057, p <0.05); higher SSS was also positively associated with ideal levels of BMI, physical activity, and fasting blood glucose levels (see Table 1).
Conclusions: These findings suggest an association between SSS and CVH among diverse Hispanic/Latino adults. Future studies will explore the mechanisms through which SSS may influence CVH.