Bias
The Problem of SES in Psychology
How social class analysis is better suited to improve health equity.
Posted March 18, 2024 Reviewed by Devon Frye
Key points
- Despite its popularity, socioeconomic status (SES) is an ambiguous concept with measurement problems.
- SES combines many social and economic assets into one number that is not useful for policy discussions.
- SES reduces economic privilege to a personal attribute removed from the social relations that produced it.
- Instead of SES, psychologists can use social class and intersectional approaches to improve health equity.
Written by Daniel J. Mulligan, MA, on behalf of the Atlanta Behavioral Health Advocates
Years ago, I casually dropped the acronym “SES” while discussing research with a friend who works as a nurse. When he asked what it meant, I was a bit surprised. Isn’t socioeconomic status (SES) common parlance in all healthcare fields?
Back then, I wanted to spread the good news about SES, this ingenious quantitative measurement that psychologists use to condense many forms of social and economic advantage into one variable. Looking back now as I finish my dissertation, I see things very differently.
I’ve realized that like my friend, I did not know what SES meant, and I’m not sure anyone does. More importantly, I argue that the way psychologists conceptualize social inequality as SES has harmful downstream consequences for millions of the most vulnerable people we study in psychology.
What is SES?
Our first problem is that social scientists cannot agree on the answer to this question. A recent review of articles published between 2000 and 2019 found researchers used 149 different measures of SES (Antonoplis, 2022). What’s more concerning is that 80 percent of those studies did not even define SES.
Most definitions agree that SES is a single number that ostensibly represents access to valued resources (Oakes & Rossi, 2003). Classically, SES has been defined in terms of income, education, and occupation (APA, 2007). But the list of socioeconomic resources relevant to psychological functioning also includes wealth, debt, benefits, prestige, social capital, and many neighborhood factors (WHO, 2010).
Because SES has no consensus definition, researchers focus on different sets of these resources, proceed to measure them in different ways, and then dub the end product “SES.” Consequently, researchers refer to different constructs with the same label (Braveman et al., 2005). Simply put, if one study includes debt in their measure of SES and another does not, they are measuring two different things.
But there’s a deeper technical problem here. Even if psychologists could agree on the list of resources that “truly” constitute SES, they have no good way to combine measures of these resources into one meaningful scale. Each measure must be converted to a standardized scale and weighted by its relative contribution to “SES.” The weights cannot be derived from factor analysis because SES is not a reflective construct like intelligence where variation in indicators (i.e., test answers) is caused by variation in intelligence (Antonoplis, 2022).
Experts now agree SES is a formative construct (i.e., variation in SES is caused by variation in its indicators). They are fiercely debating whether formative constructs have any interpretable empirical or theoretical meaning (Hardin, 2017). But even if debates work out in favor of formative constructs, the weighting problem still seems intractable. To improve scientific understanding, resources must be weighted according to theory. What a priori reason could psychologists possibly give for multiplying income by .35 instead of .52 and likewise for a dozen-and-a-half variables?
Practical Problems with SES
Useful research on the socioeconomic determinants of health should be designed to inform the public and policymakers. Yet because social movements and policies cannot target an abstraction like “low SES,” psychologists are likely to be better off modeling individual resources separately (Duncan & Magnuson, 2003). Such results are more easily interpretable and readily translated into interventions.
More issues arise when SES transforms a variety of socioeconomic advantages into one personal attribute and assigns every individual a unique position on the SES number line. This approach conceptualizes people as atomized individuals, ignores their common structural positions, and removes socioeconomic privilege from the social relations that produce it. Fortunately, social class analysis is different in all three respects.
Class, Culture, and Health Equity
Social classes are structural positions in a society’s system of economic production (i.e., how the society produces the means to survive and thrive). Classical theories of capitalist class structure identified workers, small business owners, and big business owners while newer theories highlight the intermediary role of the professional-managerial class (Ehrenreich & Ehrenreich, 1979) or define up to 12 classes based on ownership of capital, managerial authority, and educational credentials (Wright, 1984).
Essentially, a social class is a group of people united by common economic interests and struggles. So, studying a social class like “uncredentialed workers” can reveal how the mental health of millions of people suffers from the same kind of material deprivation and toxic stress caused by low social status, harsh working conditions, and denied autonomy (Eisenberg-Guyot & Hajat, 2020).
Social classes are also interdependent because economic production is interdependent. You can’t have employers without employees. Class analysis, therefore, invites questions about how the upper classes benefit at the expense of the lower classes. Health research on social class can highlight the biopsychological mechanisms by which the social relations of exploitation and domination create health inequalities.
Most importantly, social class analysis in psychology can inform structural changes to our economic, legal, and political systems. If researchers focus on individual resources, they ignore the ways in which social class determines access to those resources. They also ignore how class structure is reproduced, which in turn reproduces health disparities between classes and cultural groups. Indeed, people of Indigenous, African, and Latin American descent are disproportionately relegated to the bottom of the class structure due to historical and ongoing white supremacy (Eisenberg-Guyot & Prins, 2020).
Of course, class is just one of many interlocking systems of oppression, so psychologists can also measure socio-cultural forces like intersectional discrimination, minority stress, and cultural betrayal trauma. With these measures, they can study how class mobility is suppressed and health disparities are produced between cultural groups within the same class. If we talk as if SES accounts for all differences in power, we ignore class structure, the unique functions of individual resources, and many forms of cultural difference.
If instead, we incorporate social class analysis into curricula, research, DEI, and advocacy, we might spark more widespread discussions about how class exploitation interacts with identity-based oppression. And if enough of academia becomes conscious of its role in reproducing class hierarchy, perhaps new social norms will emerge that incentivize mass participation in community-led campaigns for health equity.
References
Antonoplis, S. (2022). Studying Socioeconomic Status: Conceptual Problems and an Alternative Path Forward. Perspect Psychol Sci, 17456916221093615. https://doi.org/10.1177/17456916221093615
American Psychological Association. (2007). Report of the APA Task Force on Socioeconomic Status.
Braveman, P. A., Cubbin, C., Egerter, S., Chideya, S., Marchi, K. S., Metzler, M., & Posner, S. (2005). Socioeconomic status in health research: one size does not fit all. JAMA, 294(22), 2879-2888.
Duncan, G. J., & Magnuson, K. A. (2003). Off with Hollingshead: Socioeconomic resources, parenting, and child development. Socioeconomic status, parenting, and child development, 287, 83-106.
Ehrenreich, B., & Ehrenreich, J. (1979). The Professional-Managerial Class. In P. Walker (Ed.), Between Labor and Capital. South End Press.
Eisenberg-Guyot, J., & Hajat, A. (2020). Under capital's thumb: Longitudinal associations between relational social class and health. J Epidemiol Community Health, 74(5), 453-459. https://doi.org/10.1136/jech-2019-213440
Eisenberg-Guyot, J., & Prins, S. J. (2020). Relational Social Class, Self-Rated Health, and Mortality in the United States. Int J Health Serv, 50(1), 7-20. https://doi.org/10.1177/0020731419886194
Hardin, A. (2017). A call for theory to support the use of causal-formative indicators: A commentary on Bollen and Diamantopoulos (2017). Psychol Methods, 22(3), 597-604. https://doi.org/10.1037/met0000115
Oakes, J. M., & Rossi, P. H. (2003). The measurement of SES in health research: current practice and steps toward a new approach. Social science & medicine, 56(4), 769-784.
World Health Organization (2010). A conceptual framework for action on the social determinants of health. https://www.who.int/publications/i/item/9789241500852
Wright, E. O. (1984). A general framework for the analysis of class structure. Politics & Society, 13(4), 383-423.