Journal of Immigrant and Minority Health

, Volume 18, Issue 2, pp 436–441 | Cite as

Determinants of Subjective Social Status and Health Among Latin American Women Immigrants in Spain: A Qualitative Approach

  • Mª Visitación Sanchón-Macias
  • Andreu Bover-Bover
  • Dolores Prieto-Salceda
  • María Paz-Zulueta
  • Blanca Torres
  • Denise Gastaldo
Original Paper


This qualitative study was carried out to better understand factors that determine the subjective social status of Latin Americans in Spain. The study was conducted following a theoretical framework and forms part of broader study on subjective social status and health. Ten immigrant participants engaged in semi-structured interviews, from which data were collected. The study results show that socioeconomic aspects of the crisis and of policies adopted have shaped immigrant living conditions in Spain. Four major themes that emerged from the analysis were related to non-recognition of educational credentials, precarious working conditions, unemployment and loneliness. These results illustrate the outcomes of current policies on health and suggest a need for health professionals to orient practices toward social determinants, thus utilizing evaluations of subjective social status to reduce inequalities in health.


Social class Subjective social status Immigration Social determinants of health Healthcare disparities Qualitative research 


Conflict of interest



  1. 1.
    International Organization for Migration. World migration report 2013: Migrant well-being and development—the seventh report in IOM’s World migration report (WMR) series. 2013.
  2. 2.
    Mladovsky P, Rechel B, Ingleby D, McKee M. Responding to diversity: an exploratory study of migrant health policies in Europe. Health Policy. 2012;105(1):1–9.CrossRefPubMedGoogle Scholar
  3. 3.
    Rechel B, Mladovsky P, Ingleby D, Mackenbach JP, McKee M. Migration and health in an increasingly diverse Europe. Lancet. 2013;381(9873):1235–45.CrossRefPubMedGoogle Scholar
  4. 4.
    Royal decree—law 16/2012 of April 20, on urgent measures for guaranteeing the sustainability of the National System of Health and improving the quality and safety of it is services (in Spanish).
  5. 5.
    Davies A, Basten A, Frattini C. Migration: A social determinant of the health of migrants. 2006.
  6. 6.
    Marmot M. Status syndrome. A challenge to medicine. JAMA. 2006;295(11):1304–7.CrossRefPubMedGoogle Scholar
  7. 7.
    Adler N, Stewart J. Health disparities across the lifespan: meaning, methods, and mechanisms. Ann N Y Acad Sci. 2010;1186:5–23.CrossRefPubMedGoogle Scholar
  8. 8.
    Adler N, Singh-Manoux A, Schwartz J, Stewart J, Matthews K, Marmot M. Social status and health: a comparison of British civil servants in Whitehall-II with European- and African-Americans in CARDIA. Soc Sci Med. 2008;66(5):1034–45.CrossRefPubMedGoogle Scholar
  9. 9.
    Wolff LS, Subramanian S, Acevedo-Garcia D, Weber D, Kawachi I. Compared to whom? Subjective social status, self-rated health, and referent group sensitivity in a diverse US sample. Soc Sci Med. 2010;70(12):2019–28.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    de Castro AB, Gee GC, Takeuchi DT. Examining alternative measures of social disadvantage among Asian Americans: the relevance of economic opportunity, subjective social status, and financial strain for health. J Immigr Minor Health. 2010;12(5):659–71.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Adler N, Stewart J. The MacArthur scale of subjective social staus. 2007.
  12. 12.
    Singh-Manoux A, Adler N, Marmot MG. Subjective social status: its determinants and its association with measures of ill-health in the Whitehall II study. Soc Sci Med. 2003;56(6):1321–33.CrossRefPubMedGoogle Scholar
  13. 13.
    Singh-Manoux A, Marmot M, Adler N. Does subjective social status predict health and change in health status better than objective status? Psychosom Med. 2005;67(6):855–61.CrossRefPubMedGoogle Scholar
  14. 14.
    Sanchón-Macias MV. Influence of subjective social status on the health of Latin American immigrant women residing in the Community of Cantabria (in Spanish). Doctoral thesis. University of the Balearic Islands, Spain. 2013.
  15. 15.
    Strauss A, Corbin J. Bases of qualitative research: techniques and procedures for developing grounded theory. Colombia: Universidad de Antioquia; 2002 (in Spanish).Google Scholar
  16. 16.
    Calderón C, Fernandez de Sanmamed MJ. Qualitative research in primary care. In: Martin ZA, Cano PJF, editors. Primary care: concepts, organization, and clinical practice. 6th ed. Barcelona: Elsevier; 2008. p. 211–40 (in Spanish).Google Scholar
  17. 17.
    National Institute of Statistics. Basic demographic indicators. Series 2002–2011. Data valid until 18 June 2013 (in Spanish). Spain.
  18. 18.
    Sanchón-Macias MV, Prieto-Salceda D, Bover-Bover A, Gastaldo D. Relationship between subjective social status and perceived health among Latin American immigrant women. Rev Lat Am Enfermagem. 2013;21(6):1353–9.CrossRefPubMedGoogle Scholar
  19. 19.
    Operario D, Adler N, Williams D. Subjective social status: reliability and predictive utility for global health. Psychol Health. 2004;19(2):237–46.CrossRefGoogle Scholar
  20. 20.
    Franzini L, Fernandez-Esquer M. The association of subjective social status and health in low-income Mexican-origin individuals in Texas. Soc Sci Med. 2006;63(3):788–804.CrossRefPubMedGoogle Scholar
  21. 21.
    Cundiff JM, Smith TW, Uchino BN, Berg CA. Subjective social status: construct validity and associations with psychosocial vulnerability and self-rated health. Int J Behav Med. 2013;20(1):148–58.CrossRefPubMedGoogle Scholar
  22. 22.
    Labonté R, Schrecker T. Globalization and social determinants of health: promoting health equity in global governance (part 3 of 3). Glob Health. 2007;3:7.CrossRefGoogle Scholar
  23. 23.
    Navarro V. Neoliberalism as a class ideology; or, the political causes of the growth of inequalities. Int J Health Serv. 2007;37(1):47–62.CrossRefPubMedGoogle Scholar
  24. 24.
    Guruge S, Khanlou N, Gastaldo D. Intimate male partner violence in the migration process: intersections of gender, race and class. J Adv Nurs. 2010;66(1):103–13.CrossRefPubMedGoogle Scholar
  25. 25.
    World Health Organization. World conference on social determinants of health. Closing the gap: policy into practice on social determinants of health. 2011.
  26. 26.
    Benach J, Muntaner C, Tarafa G, Valverde C. Social services are on sale and so is our health. Barcelona: Icaria; 2012 (in Spanish).Google Scholar
  27. 27.
    Cortés I, Gonzalez B. The economic-financial crisis and health in Spain. Evidence and viewpoints. SESPAS report 2014. Gac Sanit. 2014;28(Suppl 1):1–6 (in Spanish).CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Mª Visitación Sanchón-Macias
    • 1
  • Andreu Bover-Bover
    • 2
  • Dolores Prieto-Salceda
    • 3
  • María Paz-Zulueta
    • 1
  • Blanca Torres
    • 1
  • Denise Gastaldo
    • 4
  1. 1.Departamento de Enfermería, Escuela de EnfermeríaUniversidad de CantabriaSantanderSpain
  2. 2.Department of NursingUniversity of Islas BalearesPalma de MallorcaSpain
  3. 3.Observatorio de Salud Pública de CantabriaSantanderSpain
  4. 4.Bloomberg Faculty of NursingUniversity of TorontoTorontoCanada

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