Subjective socioeconomic status and health: Relationships reconsidered

Subjective status, an individual's perception of her socioeconomic standing, is a robust predictor of physical health in many societies. To date, competing interpretations of this correlation remain unresolved. Using longitudinal data on 8430 older adults from the 2000 and 2007 waves of the Indonesia Family Life Survey, we test these oft-cited links. As in other settings, perceived status is a robust predictor of self-rated health, and also of physical functioning and nurse-assessed general health. These relationships persist in the presence of controls for unobserved traits, such as difficult-to-measure aspects of family background and persistent aspects of personality. However, we find evidence that these links likely represent bi-directional effects. Declines in health that accompany aging are robust predictors of declines in perceived socioeconomic status, net of observed changes to the economic profile of respondents. The results thus underscore the social value afforded good health status.

► Study revisits the subjective SES–health link to clarify the interpretation of this widely-reported association.
► Demonstrates a robust relationship between perceived social status and multiple health measures in a low-income population.
► Analysis employs statistical methods with panel data that rule out several artifactual explanations of this relationship.
► Questions dominant portrayal of relationship as unidirectional; equally strong evidence that health affects subjective status.
► Among older Indonesians, perceived status decreases with declining health, net of changes to individual economic profiles.