Subjective social status and common mental disorders among Swedish workers: A longitudinal study

Abstract Background Common mental disorders (CMD) have increased in Sweden, particularly among young women. One acknowledged predictor of CMD is subjective social status (SSS). The aim was to investigate predictors and CMD outcomes of SSS in different gender and age groups of Swedish employees. Methods Data came from eight waves of the Swedish Longitudinal Occupational Survey of Health (SLOSH) from the years 2006-2020 (n = 12,925). Fixed effects models were used to investigate if changes in demographic and socioeconomic (SES) factors predicted a changed SSS and if a changed SSS in turn affected symptoms of depression and sleep disturbances. The analyses were stratified by gender (female/male) and age (21-35/36-50 years). SSS was measured using a 10-rung ladder scale, with higher values denoting higher social status. Results Across groups, the most consistent predictors of a changed SSS were being promoted, which increased SSS (women 36-50: 0.15, 95 % CI: 0.08; 0.23, men 36-50: 0.12 CI: 0.03; 0.20), and a change in occupational status, with higher occupational level increasing SSS (women 21-35: -0.13, CI: -0.23; -0.03, men 36-50: -0.07, CI: -0.11; -0.03). An increase in SSS was associated with a decrease in symptoms of depression in women in both age groups (women 21-35: -0.09 SD per 1 unit increase in SSS, CI: -0.17; -0.01, women 36-50: -0.04, CI: -0.07; -0.01) and in men in the older age group (-0.04, CI: -0.07; -0.02). The association was stronger in younger women than in older (p = 0.042). For both women and men in the older age group an increase in SSS was associated with a decrease in symptoms of sleep disturbances (women 36-50: -0.05, CI: -0.07; -0.03, men 36-50: -0.06, CI: -0.09; -0.03). Conclusions Occupational level was the most important predictor of SSS across groups and SSS predicted CMD. A change in SSS affected young working women's depressive symptoms particularly while there was an association between SSS and symptoms of sleep disturbances for older workers. Key messages • Occupational level was the most important predictor of SSS across groups. • A change in subjective social status affected young working women’s depressive symptoms particularly.