[Subjective social status and health-related quality of life among adults in Germany. Results from the German General Social Survey (ALLBUS 2010)]

Background: The impact of subjective perception of social status on health has been analysed in international health research for several years. However, in Germany the empirical analysis of the relation between subjective social status (SSS) and health is still in the very early stages. This study investigates if health-related quality of life (HRQoL) in German adults is associated with SSS over and above conventional measures of social status.

Methods: The results are based on the German General Social Survey (ALLBUS 2010), a representative cross-sectional survey of the adult resident population in Germany (n=2 827). HRQoL was assessed with 4 items referring to self-rated health (SRH) and impairment of well-being due to bodily pain, depressiveness, and loneliness. SSS was measured with a 10-point scale where participants rated their status in society. The impact of SSS on HRQoL was analysed separately for men and women using logistic regression models adjusted for age, school education, net equivalent household income, and occupational position.

Results: Poorer SRH, bodily pain, depressiveness, and loneliness occurred significantly more often in men and women with low SSS compared to those with higher SSS. After adjusting for age, education, income, and occupation, the effects of SSS on SRH and depressiveness remained significant in men and women (SRH: men: OR=4.76; 95% CI=2.52-8.99; women: OR=2.95; 95% CI=1.74-4.99; depressiveness: men: OR=2.86; 95% CI=1.60-5.10; women: OR=2.75; 95% CI=1.65-4.56). The effects of SSS on bodily pain and loneliness were observed only in women after adjustment for objective status indicators (OR=1.75; 95% CI=1.07-2.86 and OR=3.03; 95% CI=1.43-6.42, respectively).

Conclusion: These findings indicate that self-perception of social disadvantage affects HRQoL in German adults independently and partly gender-specifically. Hence, complementary to objective status indicators the SSS offers additional potential for describing and explaining health inequalities.