This analysis finds that subjective social status affects ambulatory blood pressure in African American adults, suggesting income may influence this relationship.
Subjective perceptions of social status (SSS) are associated with health. However, the literature on the associations between various indicators of SSS and blood pressure specifically is mixed. We sought to shed light on this mixed literature by examining differential associations between SSS ratings with different social group reference points and ambulatory blood pressure (ABP). We hypothesized that lower SSS ratings would be associated with higher ABP and that these associations would be stronger for those having lower income. A sample of 155 African American emerging adults (72% women) participated in lab visits and ABP monitoring for 2 to 4 days. The MacArthur Scale was used to measure SSS with respect to community (SSS-Community) and the United States population (SSS-US). Average daytime ABP was calculated. Regressions controlling for covariates found that lower SSS-US was associated with higher systolic and diastolic ABP, b* = -.17, p = .043 and b* = -.20, p = .048, but SSS-Community was not. Income moderated the associations between SSS-US (p = .025) and SSS-Community (p = .003) and diastolic ABP, with SSS being significantly associated with diastolic ABP in those with moderate (SSS-US: b* = -.23) or high income (SSS-US: b* = -.39; SSS-Community: b* = -.33). These findings extend the literature on associations between SSS and ABP by demonstrating that, among African American emerging adults, SSS is more strongly associated with ABP among those with higher incomes. Future research should explore biopsychosocial implications of having relatively high income paired with lower SSS.
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Zilligen et al. (2025) studied this question.
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