RESUMEN
BACKGROUND: Subjective socioeconomic status is robustly associated with many measures of health and well-being. The MacArthur Scale of Subjective Social Status (i.e., the MacArthur ladder) is the most widely used measure of this construct, but it remains unclear what exactly the MacArthur ladder measures. PURPOSE: The present research sought to explore the social and economic factors that underlie responses to the MacArthur ladder and its relationship to health. METHODS: We investigated this issue by examining the relationship between scores on the MacArthur ladder and measures of economic circumstances and noneconomic social status, as well as health and well-being measures, in healthy adults in the USA. RESULTS: In three studies (total N = 1,310) we found evidence that economic circumstances and social status are distinct constructs that have distinct associations with scores on the MacArthur ladder. We found that both factors exhibit distinct associations with measures of health and well-being and accounted for the association between the MacArthur ladder and each measure of health and well-being. CONCLUSIONS: Our findings suggest that the MacArthur ladder's robust predictive validity may result from the fact that it measures two factors-economic circumstances and social status-that are each independently associated with health outcomes. These findings provide a novel perspective on the large body of literature that uses the MacArthur ladder and suggests health researchers should do more to disentangle the social and economic aspects of subjective socioeconomic status.
Past research has found that people's subjective perception of their own socioeconomic status (SES) is associated with their health and well-being, even after controlling for traditional measures of SES such as income. But researchers still do not know why. One possibility is that subjective SES is simply a different measure of SES. Another is that it measures social status, separate from economic circumstances. We investigated this question using the MacArthur Scale of Subjective Social Status, which measures how people see their place in society. Across three studies using 1,300 adults in the USA, we found that the MacArthur Ladder measures two distinct factors: (i) economic circumstances, as measured by their income, education, housing, etc. and (ii) social status as measured by relative judgements of power, control, social influence, and their standing in their community and society. Both of these aspects of SES uniquely predict health and well-being. Our investigation demonstrates that the MacArthur ladder is good at predicting health outcomes because it measures both economic circumstances and social status. This new insight can help health researchers better understand the effects of social and economic factors on health, and to measure them more precisely.
RESUMEN
Low-income families are more likely to have a child with an early-onset Behavior Disorder (BD); yet, socioeconomic strain challenges engagement in Behavioral Parent Training (BPT). This study follows a promising pilot to further examine the potential to cost-effectively improve low-income families' engagement in and the efficiency of BPT. Low-income families were randomized to (a) Helping the Noncompliant Child (HNC; McMahon & Forehand, 2003), a weekly, mastery-based BPT program that includes both the parent and child or (b) Technology-Enhanced HNC (TE-HNC), which includes all of the standard HNC components plus a parent mobile application and therapist web portal that provide between-session monitoring, modeling, and coaching of parent skill use with the goal of improved engagement in the context of financial strain. Relative to HNC, TE-HNC families had greater homework compliance and mid-week call participation. TE-HNC completers also required fewer weeks to achieve skill mastery and, in turn, to complete treatment than those in HNC without compromising parent satisfaction with treatment; yet, session attendance and completion were not different between groups. Future directions and clinical implications are discussed.