Subjective Social Status in Adolescents With Asthma: Psychosocial and Physical Health Outcomes

• Published in: Health psychology 2020-03, Vol.39 (3), p.172-178
• Main Authors: Sweenie, Rachel, Basch, Molly, Ding, Ke, Pinto, Stefania, Chardon, Marie L., Janicke, David M., Acharya, Ratna, Fedele, David A.
• Format: Article
• Language: English
• Subjects: Activities of daily living; Adolescent; Adolescent Health; Adolescents; African Americans; Asthma; Asthma - pathology; Asthma - psychology; Body mass index; Caregiver burden; Caregivers; Daily stress; Female; Health behavior; Health disparities; Health Status; Human; Humans; Male; Mental depression; Mental Health; Morbidity; Pediatrics; Physical Health; Psychology - methods; Psychosocial Factors; Sleep; Social Status; Socioeconomic Status; Stress; Teenagers
• ISSN: 0278-6133; 1930-7810
• DOI: 10.1037/hea0000822

Objective: Asthma prevalence and morbidity are disproportionately higher among youth with lower socioeconomic status (SES). Examination of subjective social status (SSS) may improve understanding of associations between SES and health outcomes in pediatric asthma. Method: Fifty adolescents with asthma (Mage = 13.2 years, SD = 1.23; 54% male; 55.1% African American) completed the MacArthur Scale of Subjective Social Status-Youth Version, Daily Life Stressors Scale, Children's Depression Inventory-Short Form, Adolescent Sleep-Wake Scale-short version, and Asthma Control Test during the baseline visit of a study of health behaviors. Body mass index z scores (BMIz) were calculated using height and weight obtained during the visits. Hierarchical linear regressions examined associations between SSS and psychosocial and physical health outcomes, controlling for caregiver-reported objective SES. Results: Caregiver-reported objective SES was not associated with adolescent SSS. SSS−society was associated with daily stress (b = −3.14), t(47) = −2.13, p = .033; asthma control (β = .34, p = .045); BMIz (β = .38, p = .013); and sleep quality (β = .49, p = .001). SSS−community was associated with daily stress (b = −3.76), t(46) = −3.07, p = .002, and sleep quality (β = .36, p = .010). SSS was not associated with depressive symptoms. Conclusions: Adolescents' SSS may not always reflect caregiver's objective SES. Perceived social status may play a role in the experience of daily stress, asthma control, BMIz, and sleep quality among adolescents with asthma. SSS may offer a novel means of assessing health disparities in pediatric asthma.