A pilot cross-sectional investigation of chronic shame as a mediator of the relationship between subjective social status and self-rated health among middle-aged adults.

Subjective social status (SSS) is an important independent predictor of health outcomes, however, the pathways through which it affects health are poorly understood. Chronic shame has previously been suggested as a potential mechanism but this has never been investigated and the relationship between chronic shame and health is under-researched. The purpose of this pilot study was to explore whether chronic shame explains a significant portion of the association between SSS and self rated health (SRH). Two-hundred American adults aged 30-55 years were recruited via a crowd-sourcing platform and were asked to provide information on their SSS, level of chronic shame, and SRH. Chronic shame significantly mediated the relationship between SSS and SRH. This pilot study provides initial evidence that shame explains a significant portion of the relationship between subjective social status and self-rated health. These findings support the initiation of larger, longitudinal investigations into chronic shame as a mediator of the subjective social status and self-rated health relationship.