Abstract
Background:
Socioeconomic position is a social determinant of health that has been largely quantified across the spectrum of sports medicine research using objective proxies such as insurance status, zip code, or maternal education. However, objective measures do not always accurately represent one’s social status. Emerging research in health indicate that subjective social status (SSS) may be a sounder tool to utilize when measuring health outcomes and domains of well-being but little is known about how SSS is associated with physical, emotional, and mental domains of well-being in youth athletes. This study set out to measure how SSS is associated with domains of well-being among youth athletes in low-income residential areas.
Hypothesis:
Lower SSS will be associated with higher scores on all measured domains of well-being.
Methods:
A retrospective cross-sectional design was used to analyze preseason questionnaires from youth football athletes at Title 1 schools from the 2024-2025 season. SSS was the main exposure and measured using the MacArthur Scale of Subjective Social Status – Youth version, where participants scored, from 1-10, where they identify themselves within society with 10 indicating the best off in society and 1 indicating the worst off in society. Outcome measures included Pediatric PROMIS® short form measures of physical health (physical activity, physical stress, sleep disturbances), emotional health (anxiety, depression, anger) and mental health (psychological stress experienced (PSE)). Linear regression models were used to measure associations between SSS and each outcome.
Results:
The sample consisted of 162 athletes (age =15.76±1.14), with an average SSS of 6.39±1.02 reported. SSS was significantly associated with all measures of emotional health; anxiety (β=-0.96; 95%CI [-1.73, -0.20), anger (β=-0.83; 95%CI [-1.61, -0.04]), and depression (β=-0.81; 95%CI [-1.52, -0.10] Additionally, SSS was significantly associated with the mental health measure of PSE (β=-0.81; 95%CI [-1.55, -0.08). Lower SSS was associated with higher anxiety, anger, depression, and PSE. SSS was not significantly associated with any measure of physical health.
Conclusion:
In this study, youth athletes who reported lower SSS tended to report higher anxiety, anger, depression, and PSE. Understanding the connection between SSS and domains of well-being can enhance sports medicine treatment for youth athletes who may be experiencing one or more social determinants of health. Youth athletes with low socioeconomic status may be exposed to unique adverse circumstances that influence their health outcomes differently compared to peers with higher SSS. SSS may more accurately capture individual perception of social status and how it relates to well-being.