Body Mass Index and Subjective Social Status: The Coronary Artery Risk Development in Young Adults Study

Objective: Subjective social status (SSS), or perceived social status, may explain, in part, the relationship between socioeconomic status (SES) and obesity. The objective of this study was to test whether SSS mediates the relationship between two indicators of SES (income and education) and body mass index (BMI). Methods: A cross-sectional, structural equation path analysis was applied to the Coronary Artery Risk Development in Young Adults (CARDIA) study (n=2,624). The analysis tested whether SSS (MacArthur scale), education, and income were associated with BMI at the year 20 examination (adjusting for sex, age, and race), and it was hypothesized that the associations of education and income with BMI would be at least partly mediated by SSS. Results: SSS had a significant direct effect on BMI (-0.21, P=0.018). Education had a significant direct relationship with SSS (0.11, P<0.001) and a small but significant indirect relationship with BMI through SSS (-0.02, P=0.022). Although income did not have a significant direct relationship with BMI, it did have a significant indirect relationship through SSS (b=-0.05, P=0.019). Conclusions: Results are consistent with the hypothesized model in which SSS partially mediates the relationship between SES indicators and BMI.