Do social comparisons explain the association between income inequality and health?: Relative deprivation and perceived health among male and female Japanese individuals.
Do social comparisons explain the association between income inequality and health?: Relative deprivation and perceived health among male and female Japanese individuals.
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DOI：
10.1016/j.socscimed.2008.06.002
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发表时间：
2008-09
影响因子：
5.4
通讯作者：
Yamagata, Zentaro
中科院分区：
文献类型：
--
作者：
Kondo, Naoki;Kawachi, Ichiro;Subramanian, S. V.;Takeda, Yasuhisa;Yamagata, Zentaro
相对贫困被假设为收入不平等与健康之间联系的途径之一。我们在日本全国范围内的男性和女性样本中测试了这一假设。我们的调查包括22，871名男性和24，243名女性的概率样本，年龄在25-64岁之间，从他们那里收集了人口统计变量，家庭收入，职业或就业状况以及自我评估的健康状况。我们衡量相对贫困的指标是伊扎克指数，它计算每个人所遭受的贫困，作为一个函数，每个人相对于该人参考组中收入较高的其他人的总收入不足。我们模拟了几个替代参考组，包括相同职业的其他人，相同年龄组的其他人，以及生活在同一地理区域（县）的其他人，以及这些人的组合。广义估计方程表明，较高的相对剥夺与较差的自评健康。即使在控制了绝对收入以及其他社会人口因素后，健康状况不佳的比值比及其95%置信区间（CI）为1.09男性从1.10（95% CI：1.04 - 1.16）到1.16（95% CI：1.09-1.23），女性从1.10（95% CI：1.11-1.26）到1.18（95% CI：1.02 - 1.16）。因此，相对收入剥夺与自我评估的健康状况不佳相关，而与绝对收入无关，相对剥夺可能是收入不平等与人口健康之间联系的一种机制。
Relative deprivation has been hypothesized as one of the pathways accounting for the link between income inequality and health. We tested this hypothesis in a large national sample of men and women in Japan. Our survey included a probability sample of 22,871 men and 24,243 women aged 25–64, from whom information was gathered on demographic variables, household income, occupation or employment status, and self-rated health. Our measure of relative deprivation was the Yitzhaki Index, which calculates the deprivation suffered by each individual as a function of the aggregate income shortfall for each person relative to everyone else with higher incomes in that person’s reference group. We modeled several alternative reference groups, including others with the same occupation, others of the same age group, and others living in the same geographic area (prefecture), as well as combinations of these. Generalized estimating equations demonstrated that higher relative deprivation was associated with worse self-rated health. Even after controlling for absolute income as well as other sociodemographic factors, the odds ratio and its 95% confidence intervals (CI) for poor health ranged from 1.09 (95% CI: 1.02–1.16) to 1.18 (95% CI: 1.11–1.26) for men and from 1.10 (95% CI: 1.04–1.16) to 1.16 (95% CI: 1.09–1.23) for women per 1 million increase in the Yitzhaki Index. As such, relative income deprivation is associated with poor self-rated health independently of absolute income, and relative deprivation may be a mechanism underlying the link between income inequality and population health.
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