The experience of social status in a Chilean sample as a predictor of health outcomes

Abstract

This dissertation explores the complex relationship between social status and health outcomes within a Chilean sample, offering a comprehensive examination of the status syndrome proposed by Michael Marmot. The research adopts a multidisciplinary approach to investigate how the psychological experience of social status, particularly autonomy and social integration, influences physiological stress markers. The dissertation comprises two empirical studies and a theoretical discussion presented in three manuscripts.The first manuscript provides a theoretical exploration linking the status syndrome with Self-Determination Theory (SDT). By integrating concepts of autonomy and social integration from the Capability Approach with the basic psychological needs posited by SDT. In addition, this manuscript proposes a structured intervention model aimed at enhancing well-being through health promotion strategies tailored to individuals' social contexts. The second manuscript focuses on adapting and validating a measurement instrument assessing the perception of economic inequality within the Chilean context.The third manuscript empirically investigates the association between social status experiences and cardiovascular health markers, specifically blood pressure and C-reactive protein (CRP) levels. This study builds on the work of Seeman et al. (2014), which measured generalized control and social integration in relation to allostatic load, by incorporating negative affectivity as a critical component of the status syndrome. Collectively, this dissertation raises important questions about the status syndrome and underscores the need to further explore its mechanisms, particularly in diverse populations and healthcare contexts. Understanding these complexities is crucial for informing population health interventions and addressing less visible health indicators that exert a detrimental effect on health.