Low socioeconomic status and perceptions of social inadequacy and shame: findings from the Dutch SMILE study

Background: Based on presumed negative social comparisons in lower socioeconomic status groups, we set out to examine whether notions of 'internalized inferiority' are more common in these groups. Methods: Dutch Studie naar Medische Informatie en Leefwijzen in Eindhoven (SMILE) data on 1323 participants, aged 58-94 in 2008, were used to estimate odds ratios (ORs) of internalized inferiority by childhood and adulthood socioeconomic indicators. Questionnaires for social inadequacy and shame were used to measure internalized inferiority. Results: Both adulthood low educational level [OR 1.58; 95% confidence interval (CI): 1.04-2.40] and low income level (OR 1.88; 95% CI: 1.23-2.88) had substantial associations with reports of social inadequacy. Recalled childhood poverty was strongly associated with reports of shame (OR 2.20; 95% CI: 1.39-3.48). Conclusions: The socioeconomic patterning of social inadequacy and shame suggests that notions of internalized inferiority in the individual, psychological makeup might be important in the generation and maintenance of socioeconomic inequalities in health