Socioeconomic status and health compromising behaviour: it’s all about perception

Abstract

Socioeconomic status (SES) is associated with many health issues as well as health compromising behaviour (HCB), like smoking and unhealthy eating. Most research is based on objective indicators of SES such as income, education and occupation. However, subjective SES, a measure of someone’s perception of their social standing, is also related to health. Moreover, perceptions of health and HCB might also influence these SES effects. Therefore, this study examined the influence of objective and subjective SES on perceived health and HCB and the role of classifying HCB as typically high or low SES. In a cross-sectional survey, 326 Dutch respondents varying in SES completed a questionnaire consisting of measures of objective and subjective SES, perceived health, HCB and classification of those HCB in terms of SES. Data were analysed using hierarchical multiple regression-analysis. Results showed that both objective SES (B= .13, t(321)= 2.11, p= .04) and subjective SES (B= .20, t(321)= 3.15, p= .002) had an effect on perceived health. Only subjective SES (B= -.16, t(321)= -2.64, p= .01) effected HCB. The moderating effect of classifying HCB as typically high or low SES was only present in the relation between objective SES and HCB (B= -.30, t(318)= -5.31, p< .001). Not only SES, but especially perceptions of SES and HCB determine the extent to which someone feels healthy and engages in HCB. Health interventions should try to tackle these perceptions, either by invalidating current SES related perceptions or by emphasizing new healthy perceptions.