Perceived socioeconomic status: A new type of identity that influences adolescents' self-rated health

Purpose: The cognitive, social, and biological transitions of adolescence suggest that subjective perceptions of social position based on the socioeconomic hierarchy may undergo important changes during this period; yet how such perceptions develop is poorly understood, and no studies have assessed whether changes in such perceptions influence adolescents' health. This study describes adolescents' subjective perceptions of familial socioeconomic status (SSS), how SSS changes over time, and how age, race, and objective socioeconomic status (SES) indicators influence SSS. In addition, the study determines whether SSS independently influences adolescents' self-rated health, an important predictor of morbidity and health service use. Methods: A total of 1179 non-Hispanic black and white baseline 7-12th graders from a Midwestern public school district completed a validated, teen-specific measure of SSS annually for 4 consecutive years. A parent provided information on SES. Markov modeling assessed transitions in SSS over time. Results: SSS declined with age (p =.001) and stabilized among older teens. In addition to age, SES and race, but not gender, were significant correlates of SSS, but the relationships between these factors were complex. In cross-sectional and longitudinal analyses, black teens from families with low parent education had higher SSS than white teens from similarly educated families, whereas white teens from highly educated families had higher SSS than black teens from highly educated families. Lower SSS and changes in SSS predicted poor self-rated health even when adjusting for race and objective SES measures. Conclusion: Subjective evaluations of socioeconomic status predict adolescents' global health ratings even when adjusting for the sociodemographic factors that shape them. (c) 2007 Society for Adolescent Medicine. All rights reserved.