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Associations of relative income deprivation with perceived happiness and self-rated health among the Hong Kong Chinese population

  • Original Article
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International Journal of Public Health

Abstract

Objectives

To investigate the association of relative income deprivation (RID) with perceived happiness and self-rated health in Hong Kong.

Methods

We measured RID on Yitzhaki indices constructed using multiple reference groups and used multilevel ordinal logistic regression models to assess its linkages with the two outcomes, using data from 6272 respondents from a large-scale representative household survey.

Results

Among the overall population, increased RID was found to be consistently associated with reduced perceived happiness, even after adjusting for respondents’ level of absolute income and other socio-demographic covariates; however, there were no consistent associations between RID and self-rated health. In subgroup analysis, we observed significant linkages between RID and self-rated health only among men, the middle and older age ranges, and among those with less education and those not engaged in economic activities.

Conclusions

Our findings suggest that RID is adversely associated with perceived happiness. However, its negative linkage with self-rated health is less clear. The weak tie between RID and self-rated health may relate to the Hong Kong context, where the public health system is relatively equitable and has multiple pro-poor health policies.

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References

  • Adjaye-Gbewonyo K, Kawachi I (2012) Use of the Yitzhaki Index as a test of relative deprivation for health outcomes: a review of recent literature. Soc Sci Med 75(1):129–137

    Article  PubMed  Google Scholar 

  • Alesina A, Di Tella R, MacCulloch R (2004) Inequality and happiness: are Europeans and Americans different? J Public Econ 88(9):2009–2042

    Article  Google Scholar 

  • Armstrong BG, Sloan M (1989) Ordinal regression models for epidemiologic data. Am J Epidemiol 129(1):191–204

    Article  CAS  PubMed  Google Scholar 

  • Asadullah MN, Xiao S, Yeoh E (2015) Subjective well-being in China, 2005–2010: the role of relative income, gender, and location. China Econ Rev. http://dx.doi.org/10.1016/j.chieco.2015.12.010

  • Buhmann B, Rainwater L, Schmaus G, Smeeding TM (1988) Equivalence scales, well-being, inequality, and poverty: sensitivity estimates across ten countries using the Luxembourg income study (LIS). Database Rev Income Wealth 34(2):115–142

    Article  Google Scholar 

  • C&SD (2015) Hong Kong poverty situation report 2014. Census and Statistics Department, Hong Kong

    Google Scholar 

  • Demakakos P, Nazroo J, Breeze E, Marmot M (2008) Socioeconomic status and health: the role of subjective social status. Soc Sci Med 67(2):330–340

    Article  PubMed  Google Scholar 

  • DeSalvo KB, Bloser N, Reynolds K, He J, Muntner P (2006) Mortality prediction with a single general self-rated health question. J Gen Intern Med 21(3):267–275

    Article  PubMed  PubMed Central  Google Scholar 

  • Eibner C, Evans WN (2005) Relative deprivation, poor health habits, and mortality. J Human Res 40(3):591–620

    Article  Google Scholar 

  • Elstad JI (1998) The psycho-social perspective on social inequalities in health. Sociol Health Illn 20(5):598–618

    Article  Google Scholar 

  • Franzini L, Fernandez-Esquer ME (2006) The association of subjective social status and health in low-income Mexican-origin individuals in Texas. Soc Sci Med 63(3):788–804

    Article  PubMed  Google Scholar 

  • Gravelle H, Sutton M (2009) Income, relative income, and self-reported health in Britain 1979–2000. Health Econ 18(2):125–145

    Article  PubMed  Google Scholar 

  • Hounkpatin HO, Wood AM, Dunn G (2016) Does income relate to health due to psychosocial or material factors? Consistent support for the psychosocial hypothesis requires operationalization with income rank not the Yitzhaki Index. Soc Sci Med 150:76–84. doi:10.1016/j.socscimed.2015.12.008

    Article  PubMed  Google Scholar 

  • Johnston JM et al (2006) Non-attendance and effective equity of access at four public specialist outpatient centers in Hong Kong. Soc Sci Med 62(10):2551–2564

    Article  PubMed  Google Scholar 

  • Jones AM, Wildman J (2008) Health, income and relative deprivation: vidence from the BHPS. J Health Econ 27(2):308–324

    Article  PubMed  Google Scholar 

  • Jylhä M (2009) What is self-rated health and why does it predict mortality? Towards a unified conceptual model. Soc Sci Med 69(3):307–316

    Article  PubMed  Google Scholar 

  • Kawachi I, Kennedy BP (1999) Income inequality and health: pathways and mechanisms. Health Serv Res 34(1 Pt 2):215

    CAS  PubMed  PubMed Central  Google Scholar 

  • Kondo N, Kawachi I, Subramanian S, Takeda Y, Yamagata Z (2008) Do social comparisons explain the association between income inequality and health?: Relative deprivation and perceived health among male and female Japanese individuals. Soc Sci Med 67(6):982–987

    Article  PubMed  PubMed Central  Google Scholar 

  • Kondo N, Sembajwe G, Kawachi I, van Dam RM, Subramanian S, Yamagata Z (2009) Income inequality, mortality, and self rated health: meta-analysis of multilevel studies. Bmj 339:b4471

    Article  PubMed  PubMed Central  Google Scholar 

  • Kuo C-T, Chiang T-l (2013) The association between relative deprivation and self-rated health, depressive symptoms, and smoking behavior in Taiwan. Soc Sci Med 89:39–44

    Article  PubMed  Google Scholar 

  • Kye SY, Park K (2014) Health-related determinants of happiness in Korean adults. Int J Publ Health 59(5):731–738

    Article  Google Scholar 

  • Leung GM, Tin KY, O’Donnell O (2009) Redistribution or horizontal equity in Hong Kong’s mixed public–private health system: a policy conundrum. Health Econ 18(1):37–54

    Article  PubMed  Google Scholar 

  • Li H, Zhu Y (2006) Income, income inequality, and health: evidence from China. J Compar Econ 34(4):668–693

    Article  Google Scholar 

  • Ling DC (2009) Do the Chinese “Keep up with the Jones”?: Implications of peer effects, growing economic disparities and relative deprivation on health outcomes among older adults in China. China Econ Rev 20(1):65–81

    Article  Google Scholar 

  • Liu X (2009) Ordinal regression analysis: fitting the proportional odds model using Stata, SAS and SPSS. J Mod Appl Stat Meth 8(2):30

    Google Scholar 

  • Lorgelly PK, Lindley J (2008) What is the relationship between income inequality and health? Evidence from the BHPS. Health Econ 17(2):249–265

    Article  PubMed  Google Scholar 

  • Lynch JW, Smith GD, Kaplan GA, House JS (2000) Income inequality and mortality: importance to health of individual income, psychosocial environment, or material conditions. Br Med J 320(7243):1200

    Article  CAS  Google Scholar 

  • Lyubomirsky S, Lepper HS (1999) A measure of subjective happiness: preliminary reliability and construct validation. Soc Indic Res 46(2):137–155

    Article  Google Scholar 

  • Mishra S, Carleton RN (2015) Subjective relative deprivation is associated with poorer physical and mental health. Soc Sci Med 147:144–149. doi:10.1016/j.socscimed.2015.10.030

    Article  PubMed  Google Scholar 

  • O’donnell O et al (2008) Who pays for health care in Asia? J Health Econ 27(2):460–475

    Article  PubMed  Google Scholar 

  • Oshio T, Kobayashi M (2010) Income inequality, perceived happiness, and self-rated health: evidence from nationwide surveys in Japan. Soc Sci Med 70(9):1358–1366

    Article  PubMed  Google Scholar 

  • Oshio T, Nozaki K, Kobayashi M (2011) Relative income and happiness in Asia: evidence from nationwide surveys in China, Japan, and Korea. Soc Indic Res 104(3):351–367

    Article  Google Scholar 

  • Salti N (2010) Relative deprivation and mortality in South Africa. Soc Sci Med 70(5):720–728

    Article  PubMed  Google Scholar 

  • Scott SC, Goldberg MS, Mayo NE (1997) Statistical assessment of ordinal outcomes in comparative studies. J Clin Epidemiol 50(1):45–55. doi:10.1016/S0895-4356(96)00312-5

    Article  CAS  PubMed  Google Scholar 

  • Singer E (1981) Reference groups and social evaluations. Social psychology: sociological perspectives, pp 66–93

  • Smith HJ, Pettigrew TF, Pippin GM, Bialosiewicz S (2012) Relative deprivation a theoretical and meta-analytic review. Pers Soc Psychol Rev 16(3):203–232

    Article  CAS  PubMed  Google Scholar 

  • Subramanian S, Kim D, Kawachi I (2005) Covariation in the socioeconomic determinants of self rated health and happiness: a multivariate multilevel analysis of individuals and communities in the USA. J Epidemiol Community Health 59(8):664–669

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Subramanyam M, Kawachi I, Berkman L, Subramanian SV (2009) Relative deprivation in income and self-rated health in the United States. Soc Sci Med 69(3):327–334. doi:10.1016/j.socscimed.2009.06.008

    Article  PubMed  Google Scholar 

  • Wildman J (2003) Income related inequalities in mental health in Great Britain: analysing the causes of health inequality over time. J Health Econ 22(2):295–312

    Article  PubMed  Google Scholar 

  • Wilkinson RG, Pickett KE (2006) Income inequality and population health: a review and explanation of the evidence. Soc Sci Med 62(7):1768–1784

    Article  PubMed  Google Scholar 

  • Wu X (2014) Hong Kong panel study of social dynamics: research designs and preliminary findings. Hong Kong Macao J 4:008

    Google Scholar 

  • Yitzhaki S (1983) On an extension of the Gini inequality index. Int Econ Rev 617–628. doi:10.2307/2648789

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Acknowledgements

This study was supported by the Chief Executive’s Community Projects, The Hong Kong Jockey Club Charities Trust (Project Number: 2013/CP03).

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Correspondence to Paul Siu Fai Yip.

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Research ethics

Ethical approval was obtained from the Hong Kong University of Science and Technology, Hong Kong (Ref No. HKUST-6001-SPPR-08).

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The authors declare no conflict of interest.

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Chan, C.H., Wong, H.K. & Yip, P.S.F. Associations of relative income deprivation with perceived happiness and self-rated health among the Hong Kong Chinese population. Int J Public Health 62, 697–707 (2017). https://doi.org/10.1007/s00038-017-0953-x

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  • DOI: https://doi.org/10.1007/s00038-017-0953-x

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