Goodman Elizabeth, Maxwell Sarah, Malspeis Susan, Adler Nancy
Pediatrics. 2015 Sep;136(3):e633-40. doi: 10.1542/peds.2015-1300.
Subjective social status (SSS), a person's sense of their (or for youth, abstract their family's) position in the socioeconomic hierarchy, is strongly related to health in adults but not health in adolescence. Understanding this developmental discrepancy requires first understanding the developmental trajectory of SSS. The objective of this study was to identify the number and shape of SSS trajectories as adolescents transition to adulthood and explore if trajectory membership affects health.
Using data from 7436 assessments from the Princeton School District Study, a decade long cohort study of non-Hispanic black and white youth, latent class growth models with 3 to 7 SSS trajectories were developed. Model fit, trajectory structure, and shape were used to guide optimal model selection. Using this optimal model, the associations of trajectory membership with BMI and depressive symptoms in young adulthood were explored.
The 5-class model was optimal. In this model, trajectories were persistent high (7.8%),mid–high (32.2%), middle (43.4%), low–lower (7.4%), and high–low (9.1%). Non-Hispanic black race/ethnicity, lower household income, and low parent education were associated with membership in this high–low trajectory. High–low trajectory membership was associated with higher BMI and depressive symptoms in non-Hispanic white subjects but was not associated with depressive symptoms. It was associated with lower BMI only after adjustment for BMI in adolescence in non-Hispanic black subjects.
SSS is relatively stable in adolescence and the transition to adulthood, and it generally reflects objective markers of social advantage. However, socially disadvantaged youth with high SSS in early adolescence may be at increased health risk.
主观社会地位(SSS)是指一个人(或对于青少年而言,抽象为其家庭)在社会经济等级制度中的地位感,它与成年人的健康密切相关,但与青少年的健康无关。要理解这种发展差异,首先需要了解SSS的发展轨迹。本研究的目的是确定青少年向成年期过渡时SSS轨迹的数量和形态,并探讨轨迹成员身份是否会影响健康。
利用普林斯顿学区研究长达十年的队列研究中7436次评估的数据,开发了具有3至7条SSS轨迹的潜在类别增长模型。模型拟合、轨迹结构和形态用于指导最优模型的选择。利用这个最优模型,探讨了轨迹成员身份与青年期体重指数(BMI)和抑郁症状之间的关联。
五类模型是最优的。在这个模型中,轨迹分别为持续高(7.8%)、中高(32.2%)、中等(43.4%)、低低(7.4%)和高低(9.1%)。非西班牙裔黑人种族/族裔、较低的家庭收入和较低的父母教育程度与该高低轨迹的成员身份相关。高低轨迹成员身份与非西班牙裔白人受试者较高的BMI和抑郁症状相关,但与抑郁症状无关。在非西班牙裔黑人受试者中,仅在对青少年期BMI进行调整后,它与较低的BMI相关。
SSS在青少年期和向成年期的过渡过程中相对稳定,并且它通常反映社会优势的客观指标。然而,青春期早期具有高SSS的社会弱势青年可能面临更高的健康风险。