Social stability and health: exploring multidimensional social disadvantage

Social stability is an understudied construct in public health that offers a useful framework for understanding social disadvantage across multiple domains. This study investigated prevalence and patterns of cooccurrence among a hypothesized set of social stability characteristics (housing, residential transition, employment, income, incarceration, and partner relationship), evaluated the possibility of underlying subgroups of social stability, and investigated the association between social stability and health outcomes. Data were from comprehensive interviews with primarily African-American low income urban women and their female social network members (n = 635) in Baltimore. Analysis included exploratory statistics, latent class analysis, and latent class regression accounting for clustered data using Stata and Mplus software. Social stability characteristics cooccurred in predictable directions, but with heterogeneity. Respondents had an average of three stability characteristics (S.D.: 1.4). Latent class analysis identified two classes of social stability: low (25%) and high (75%), with the higher class less likely to experience each of the included indicators. In controlled models, higher social stability was significantly correlated with social network characteristics and neighborhood integration. Higher social stability was independently associated with reduced risk of chronic illness (AOR: 0.54, 95% C.I.: 0.31, 0.94), mental illness history (AOR: 0.24, 95% CI: 0.15, 0.39), and current depressive symptoms (AOR: 0.35, 95% C.I.: 0.22, 0.57). The current set of social stability characteristics appears to represent a single construct with identifiable underlying subgroups and associated health disparities. Findings suggest a need for comprehensive policies and programs that address structural determinants of cooccurring social disadvantage and help to mitigate the likely spiral effect of instability experiences.