Latinos’ beliefs about social status may affect their cardiovascular health, study finds

CHAMPAIGN, Ill. — Hispanics and Latinos in the U.S. who perceive themselves as having higher social status are more likely to have ideal markers of cardiovascular health, according to a new study published in the Journal of the American Heart Association.

Lead author Lissette Piedra, a professor of social work at the University of Illinois Urbana-Champaign, said it is the first study to suggest that subjective markers of social status may have stronger effects on the cardiovascular health of Hispanic and Latino populations in the U.S. than objective markers such as levels of employment, education and income.

The study included more than 15,300 Hispanic and Latino adults living in Chicago, Miami, New York and San Diego. More than three-fourths of the participants, who ranged in age from 18-74, were born in other countries, primarily Mexico and Cuba.

“Migration creates multiple socioeconomic frames of reference that influence health and behavior outcomes yet remain undetectable by objective social status measures,” Piedra said. “Latinos who held professional positions such as teachers or attorneys in their countries of origin may be constrained from finding similar work in the U.S. because of language or credential issues. For them, the migration experience coincides with a sense of diminished social status.”

Conversely, people who emigrate from Latin American communities with extremely low wages may obtain jobs that are low paying by comparison with the U.S. general population, yet their income may be multiple times what was possible in their country of origin, elevating their perceptions of social standing, Piedra said.

 Participants in the study were asked to rank themselves on a 10-rung social ladder relative to other people in the U.S. The top rung represented people with the highest prestige and success, and the bottom rung represented people with the least. On average, participants’ self- ranked social status was 4.4.

Participants’ objective social status was assessed using their educational attainment, annual income and employment status – full-time, part-time or unemployed. About 42% of the participants lived in households with annual incomes of $20,000 or less. Nearly half – 49% – were unemployed. The majority – 60% – had a high school education or less.

Their cardiovascular health was assessed as ideal, intermediate or poor based on the American Heart Association’s Life’s Simple 7, modifiable healthy lifestyle factors that include body mass index, blood pressure, dietary intake, smoking status and levels of cholesterol, glucose and physical activity.

Less than half of the participants achieved ideal scores across four or more of the seven  metrics, according to the study.

However, individuals who believed their social status was higher were more likely to have ideal scores on body mass index, physical activity and fasting blood sugar.

Each percentage point of increase in subjective social status was associated with a higher overall cardiovascular health score. The effect persisted even after the researchers adjusted for objective social status, demographic and health factors.   

Piedra said the findings provide important insights into the effects of perceived social status on Hispanics and Latinos’ cardiovascular health and could be useful in designing interventions that elevate these individuals’ senses of social status and autonomy.

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Co-authors of the study were social work professors Flavia C.D. Andrade, Rosalba Hernandez and Karen M. Tabb, all of the U. of I.; social medicine professor Krista M. Perreira and biostatistics professor Jianwen Cai, both of the University of North Carolina, Chapel Hill; and psychology professors Linda C. Gallo, Sheila F. Castaneda and Dr. Gregory A. Talavera, all of San Diego State University.

Other co-authors were neuroscience professor Hector M. Gonzalez, of the University of California, San Diego; epidemiology and population health professor Sara Gonzalez, of Albert Einstein College of Medicine; Dr. Martha L. Daviglus and research specialist Jingsong Chen, both of the U. of I. College of Medicine, Chicago; and Ramon A. Durazo-Arvizu, the director of the biostatistics and data analysis core, Children’s Hospital Los Angeles.

The research was supported by the National Heart, Lung and Blood Institute; the National Center on Minority Health and Health Disparities; and the National Institute of Deafness and Other Communication Disorders, among other organizations.