Subjective social status in later life: Social determinants and health implications in India

Subjective Social Status (SSS), defined as an individual’s perceived position within the social hierarchy, has been shown to capture psychosocial dimensions of inequality that are not fully reflected by objective socioeconomic indicators. Although SSS has been widely examined in high-income countries, evidence from rapidly ageing and socially stratified low- and middle-income countries (LMICs), such as India, remains limited. Understanding the social, economic, and health-related determinants of SSS, as well as its association with health perceptions, is important for informing holistic approaches to ageing and care. To examine the determinants of SSS among adults aged 45 years and above in India and to assess the association between SSS and self-rated health (SRH), after accounting for objective socioeconomic and health-related characteristics. The study used nationally representative data from the Longitudinal Ageing Study in India (LASI), Wave 1 (2017–18). Shapley decomposition was used to identify the structural and psychosocial determinants of SSS across individual, household, institutional, and health-related domains. Secondly, SSS was introduced into stepwise regression models of self-rated health to assess whether perceived social status contributes to health outcomes beyond conventional socioeconomic indicators. Finally, Generalised Ordered Logistic Regression models were estimated to account for the ordinal nature of the health outcome and to test the robustness of the observed associations. Variation in SSS was primarily explained by education, household economic standing, place of residence, and mental and cognitive health. Education emerged as the single largest contributor to perceived social status. In stepwise regression models, SSS remained strongly and independently associated with self-rated health after adjustment for socioeconomic, institutional, and health-related factors. SSS remained a significant predictor of SRH, accounting for 59.7 % of the explained variance even after adjusting for traditional socioeconomic factors. Perceived social standing reflects cumulative social, economic, and psychosocial experiences and is strongly patterned by structural inequalities in later life. These findings highlight the importance of integrating subjective measures such as SSS alongside objective indicators can enhance understanding of health and wellbeing in ageing populations, particularly in LMICs.