Income, Relative Deprivation and the Self-Rated Health of Older People in Urban and Rural China

Abstract

Background: Substantial evidence indicated that absolute income is directly associated with health. Few studies have, however, examined if relative income may be equally associated with health. This study aimed to investigate the association between absolute income/relative deprivation (RD) and self-rated health (SRH). We also investigated whether the urban-rural difference was existing in these associations.Methods: Using cross-sectional data of 7,070 participants in the Shandong Family Health Service Survey of older people, this study applied binary logistic model and semi-parametric model to estimate the effect of absolute income and relative deprivation on SRH of older people. The Kakwani Index was used as a measure of relative deprivation at the individual level.Results: Absolute income has a significant positive effect on the SRH among both urban and rural older people. When considered RD as a variable, both absolute income and RD have negative significant effects on SRH among all older people. In addition, the negative effect of RD on rural elderly is more pronounced than that of urban older populations. Semi-parametric regression results show that there was a complex non-linear relationship between income and SRH. Psychological distress substantially attenuated the association between relative deprivation and SRH.Conclusions: Relative deprivation is negatively associated with self-rated health in both urban and rural older people after controlling the absolute income. RD may partly explain the association between income inequality and worse health status. Compared with the urban elderly, the effect of income-based relative deprivation on SRH was more pronounced among the rural elderly, and more care should be given to the lower income and rural older populations.

Different impact on health outcomes of long-term care insurance between urban and rural older residents in China

“…As fears grow about the burden of government finance, the establishment of a reasonable individual-social-government payment mechanism might be essential 43 . The relative deprivation may have a greater negative impact on older rural people, which could explain the finding that poorer health status was associated with low income 44 . Moreover, low income further resulted in older rural adults acquiring less individual social capital, thus affecting their health-related quality of life 45 .…”

Exploring Chinese Elderly’s Trust in the Healthcare System: Empirical Evidence from a Population-Based Survey in China

“…The existing empirical studies in China revealed that subjective SES was highly related to health. Invidious upward social comparisons would lead to perceived relative deprivation, which is negatively associated with self-rated health in both urban and rural older people [ 52 ]. Current studies based on a large-scale survey, such as China Family Panel Studies, also showed that subjective social status was correlated with health, personal relative deprivation had negative effects on the health of the Chinese population, and individuals with high expected mobility were found to have significantly better health [ 50 ].…”

“…The relative deprivation has already threatened political trust [ 60 ]. The lower the income of the elderly, the more difficult it is to meet their own needs, and they are more likely to be in a disadvantaged position when making social comparisons with others, resulting in relative deprivation [ 52 ]. The results of our research implied that lower self-rated SES and upward mobility of the elderly might signal a sense of relative deprivation, which contributed to the low trust in the health system.…”

Regional agricultural cooperatives and subjective wellbeing of rural households in China

“…The extant literature suggests that income plays a significant role in the mental health of households (Duong & Bradshaw, 2016; Qin et al, 2021; Shields‐Zeeman et al, 2021). Households with lower income are more likely to have poor health.…”

“…Subjective wellbeing is considered a dimension of mental health (Jans‐Beken et al, 2018; Keyes, 2005; Westerhof & Keyes, 2010). Literature suggests that farmers’ mental health is affected by household income (Duong & Bradshaw, 2016; Qin et al, 2021; Shields‐Zeeman et al, 2021) and social capital (Akaeda, 2021; Fiorillo et al, 2020; Lin et al, 2019), as well as the farming (agricultural) work environment, including financial instability, isolation and chemical exposure (Fraser et al, 2005; Judd et al, 2006). In addition, supplemental off‐farm employment is also associated with higher levels of mental distress (Logstein, 2016).…”