Relative to Whom? Social Status, Blood Pressure, and How Inequality Gets under the Skin

Amelia Karraker, University of Wisconsin-Madison

Subjective social status (SSS) measures are more strongly associated with health than occupational status and do not exclude those without work histories. An additional benefit of SSS measures is that they can capture the multiple contexts in which social status may be salient for health. I examine the relationship between SSS measures (relative to peers, relative to Americans) and blood pressure, an outcome particularly affected by the stress of low status. Because of the connections between social status, socioeconomic status (SES), health literacy, and medical care access, I focus on biomarker measures of blood pressure rather than physician diagnosis of hypertension. I find that higher SSS is associated with better blood pressure even after controlling for SES. SSS relative to Americans is associated with blood pressure independent of SSS relative to peers. In contrast, lower SSS is associated with lower prevalence of physician diagnosis of hypertension.