Background

Socioeconomic status (SES) is defined as a total measure of an individual’s economic or social position in relation to others. Income and educational level are often used as quantifiable objective measures of SES but are inherently limited. Perceived SES (p-SES), refers to an individual’s perception of their own SES. Herein, we assess the correlation between objective SES (o-SES) as defined by income and educational level and p-SES after injury and compare their associations with long-term outcomes after injury.

Methods

Moderate-to-severely injured patients admitted to a Level 1 trauma center were asked to complete a phone-based survey assessing functional and mental health outcomes, social dysfunction, chronic pain, and return to work/school 6-12 mo postinjury. o-SES was determined by income and educational level (low educational level: high school or lower; low income: live in zip code with median income/household lower than the national median). p-SES was determined by asking patients to categorize their SES. The correlation coefficient between o-SES and p-SES was calculated. Multivariate logistic regression models were built to determine the associations between o-SES and p-SES and long-term outcomes.

Results

A total of 729 patients were included in this study. Patients who reported a low p-SES were younger, more likely to suffer penetrating injuries, and to have a weak social support network. Twenty-one percent of patients with high income and high educational level classified their p-SES as low or mid-low, and conversely, 46% of patients with low education and low income classified their p-SES as high or mid-high. The correlation coefficient between p-SES and o-SES was 0.2513. After adjusting for confounders, p-SES was a stronger predictor of long-term outcomes, including functional limitations, social dysfunction, mental health outcomes, return to work/school, and chronic pain than was o-SES.

Conclusions

Patient-reported p-SES correlates poorly with o-SES indicating that the commonly used calculation of income and education may not accurately capture an individuals’ SES. Furthermore, we found p-SES to be more strongly correlated with long-term outcome measures than o-SES. As we strive to improve long-term outcomes after injury, p-SES may be an important variable in the early identification of individuals who are likely to suffer from worse long-term outcomes after injury.

中文翻译：

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感知的社会经济地位：受伤后长期结果的有力预测因素

背景

社会经济地位（SES）被定义为个人相对于他人的经济或社会地位的总体衡量标准。收入和教育水平通常被用作社会经济地位的量化客观衡量标准，但本质上是有限的。感知SES（p-SES），是指个人对自己SES的感知。在这里，我们评估了由收入和教育水平定义的客观 SES (o-SES) 与受伤后 p-SES 之间的相关性，并将它们与受伤后的长期结果进行比较。

方法

要求入住 1 级创伤中心的中度至重度受伤患者完成一项基于电话的调查，评估功能和心理健康结果、社会功能障碍、慢性疼痛以及受伤后 6-12 个月重返工作/学校。o-SES 由收入和教育水平确定（低教育水平：高中或以下；低收入：居住在收入中位数/家庭低于全国中位数的邮政编码中）。p-SES 是通过要求患者对他们的 SES 进行分类来确定的。计算了o-SES和p-SES之间的相关系数。建立多变量逻辑回归模型以确定o-SES和p-SES与长期结果之间的关联。

结果

本研究共纳入 729 名患者。报告低 p-SES 的患者更年轻，更容易遭受穿透性伤害，并且社会支持网络较弱。21% 的高收入和高教育水平的患者将其 p-SES 分类为低或中低，相反，46% 的低教育和低收入患者将其 p-SES 分类为高或中高。p-SES 和 o-SES 之间的相关系数为 0.2513。在调整混杂因素后，p-SES 比 o-SES 更能预测长期结果，包括功能限制、社会功能障碍、心理健康结果、重返工作/学校和慢性疼痛。

结论

患者报告的 p-SES 与 o-SES 的相关性较差，这表明常用的收入和教育计算可能无法准确捕捉个人的 SES。此外，我们发现 p-SES 与长期结果测量的相关性比 o-SES 更强。当我们努力改善受伤后的长期结果时，p-SES 可能是早期识别受伤后可能遭受更差长期结果的个体的重要变量。