Abstract
Purpose
In studying health inequality, poverty as measured by income is frequently used; however, this omits the aspects of non-monetary resources and social barriers to achieving improved living standard. Therefore, our study aimed to examine the associations of individual-level deprivation of material and social necessities with general physical and mental health beyond that of income poverty.
Methods
A territory-wide two-stage stratified random sample of 2282 community-dwelling Hong Kong adults was surveyed between 2014 and 2015. Income poverty and a Deprivation Index were used as the main independent variables. General health was assessed using the validated 12-item Short-Form Health Survey version 2, from which physical component summary and mental component summary were derived.
Results
Our results in multivariable ordinal logistic regressions consistently showed that, after adjusting for income poverty, socio-demographic and lifestyle factors, being deprived was significantly associated with worse physical (OR 1.66; CI 1.25–2.20) and mental health (OR 1.83; CI 1.43–2.35). Being income poor was also significantly associated with worse mental health (OR 1.63; CI 1.28–2.09) but only marginally with physical health (OR 1.34; CI 1.00–1.80) after adjustments.
Conclusions
Income does not capture all aspects of poverty that are associated with adverse health outcomes. Deprivation of non-monetary resources has an independent effect on general health above and beyond the effect of income poverty. Policies should move beyond endowment and take into account the multidimensionality of poverty, in order to address the problem of health inequality.
In studying health inequality, poverty as measured by income is frequently used; however, this omits the aspects of non-monetary resources and social barriers to achieving improved living standard. Therefore, our study aimed to examine the associations of individual-level deprivation of material and social necessities with general physical and mental health beyond that of income poverty.
Methods
A territory-wide two-stage stratified random sample of 2282 community-dwelling Hong Kong adults was surveyed between 2014 and 2015. Income poverty and a Deprivation Index were used as the main independent variables. General health was assessed using the validated 12-item Short-Form Health Survey version 2, from which physical component summary and mental component summary were derived.
Results
Our results in multivariable ordinal logistic regressions consistently showed that, after adjusting for income poverty, socio-demographic and lifestyle factors, being deprived was significantly associated with worse physical (OR 1.66; CI 1.25–2.20) and mental health (OR 1.83; CI 1.43–2.35). Being income poor was also significantly associated with worse mental health (OR 1.63; CI 1.28–2.09) but only marginally with physical health (OR 1.34; CI 1.00–1.80) after adjustments.
Conclusions
Income does not capture all aspects of poverty that are associated with adverse health outcomes. Deprivation of non-monetary resources has an independent effect on general health above and beyond the effect of income poverty. Policies should move beyond endowment and take into account the multidimensionality of poverty, in order to address the problem of health inequality.
| Original language | English |
|---|---|
| Pages (from-to) | 2127-2135 |
| Number of pages | 9 |
| Journal | Quality of Life Research |
| Volume | 27 |
| Issue number | 8 |
| Early online date | 14 May 2018 |
| DOIs | |
| Publication status | Published - Aug 2018 |
Funding
The work described in this paper was fully supported by a Grant from the Central Policy Unit of the Government of the Hong Kong Special Administrative Region and the Research Grants Council of the Hong Kong Special Administrative Region, China (Project No. 4003-SPPR-11).
Keywords
- Deprivation
- Poverty
- Physical Health
- Mental Health
- Chinese adults
- Hong Kong
- Physical health
- Mental health
