A higher prevalence of health problems in low income groups: Does it reflect relative deprivation?

K Stronks*, HD van de Mheen, JP Mackenbach

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Study objective

Although it has frequently been suggested that income affects health, there is hardly any research in which this issue has been explored directly. The aim of this study was, firstly, to examine whether income is independently associated with health, secondly, to assess the extent to which this association reflects high levels of deprivation in low income groups, and thirdly, to examine which specific components of deprivation contribute most to the link between income and health. Health indicators used were the prevalence of chronic conditions, health complaints and less than "good" perceived general health.

Setting

Region in the south east of the Netherlands.

Participants

A population of 2567 men and women who participated in an oral interview, aged 15-74.

Design

Data were obtained from the baseline of a prospective cohort study aimed at the explanation of socioeconomic inequalities in health.

Results

Large inequalities in health by (equivalent) income after differences in other socioeconomic indicators had been controlled for were observed. For example, among those in the lowest income group the risk of bad perceived health was three times as high as among people in the highest income group. The prevalence of deprivation (basic, housing, social) increased with decreasing income to approximately 50-60% in the lowest income group. A substantial part of the increased health risks of the lowest income groups could statistically be accounted for by the higher prevalence of deprivation in these groups. The components that are likely to influence health indirectly, through a psychological or behavioural mechanism, accounted for most of the effect.

Conclusions

These analyses provide evidence to suggest that a low income has detrimental health effects through relative deprivation. Moreover, the results indicate an indirect link between deprivation and health problems involving psychological or behavioural factors.

Original languageEnglish
Pages (from-to)548-557
JournalJournal of Epidemiology and Community Health
Volume52
Issue number9
DOIs
Publication statusPublished - 1998
Externally publishedYes

Keywords

  • SOCIOECONOMIC INEQUALITIES
  • POVERTY
  • MORTALITY
  • DIFFERENTIALS
  • EXPLANATION
  • ENGLAND

Cite this

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title = "A higher prevalence of health problems in low income groups: Does it reflect relative deprivation?",
abstract = "Study objectiveAlthough it has frequently been suggested that income affects health, there is hardly any research in which this issue has been explored directly. The aim of this study was, firstly, to examine whether income is independently associated with health, secondly, to assess the extent to which this association reflects high levels of deprivation in low income groups, and thirdly, to examine which specific components of deprivation contribute most to the link between income and health. Health indicators used were the prevalence of chronic conditions, health complaints and less than {"}good{"} perceived general health.SettingRegion in the south east of the Netherlands.ParticipantsA population of 2567 men and women who participated in an oral interview, aged 15-74.DesignData were obtained from the baseline of a prospective cohort study aimed at the explanation of socioeconomic inequalities in health.ResultsLarge inequalities in health by (equivalent) income after differences in other socioeconomic indicators had been controlled for were observed. For example, among those in the lowest income group the risk of bad perceived health was three times as high as among people in the highest income group. The prevalence of deprivation (basic, housing, social) increased with decreasing income to approximately 50-60{\%} in the lowest income group. A substantial part of the increased health risks of the lowest income groups could statistically be accounted for by the higher prevalence of deprivation in these groups. The components that are likely to influence health indirectly, through a psychological or behavioural mechanism, accounted for most of the effect.ConclusionsThese analyses provide evidence to suggest that a low income has detrimental health effects through relative deprivation. Moreover, the results indicate an indirect link between deprivation and health problems involving psychological or behavioural factors.",
keywords = "SOCIOECONOMIC INEQUALITIES, POVERTY, MORTALITY, DIFFERENTIALS, EXPLANATION, ENGLAND",
author = "K Stronks and {van de Mheen}, HD and JP Mackenbach",
year = "1998",
doi = "10.1136/jech.52.9.548",
language = "English",
volume = "52",
pages = "548--557",
journal = "Journal of Epidemiology and Community Health",
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}

A higher prevalence of health problems in low income groups : Does it reflect relative deprivation? / Stronks, K; van de Mheen, HD; Mackenbach, JP.

In: Journal of Epidemiology and Community Health, Vol. 52, No. 9, 1998, p. 548-557.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - A higher prevalence of health problems in low income groups

T2 - Does it reflect relative deprivation?

AU - Stronks, K

AU - van de Mheen, HD

AU - Mackenbach, JP

PY - 1998

Y1 - 1998

N2 - Study objectiveAlthough it has frequently been suggested that income affects health, there is hardly any research in which this issue has been explored directly. The aim of this study was, firstly, to examine whether income is independently associated with health, secondly, to assess the extent to which this association reflects high levels of deprivation in low income groups, and thirdly, to examine which specific components of deprivation contribute most to the link between income and health. Health indicators used were the prevalence of chronic conditions, health complaints and less than "good" perceived general health.SettingRegion in the south east of the Netherlands.ParticipantsA population of 2567 men and women who participated in an oral interview, aged 15-74.DesignData were obtained from the baseline of a prospective cohort study aimed at the explanation of socioeconomic inequalities in health.ResultsLarge inequalities in health by (equivalent) income after differences in other socioeconomic indicators had been controlled for were observed. For example, among those in the lowest income group the risk of bad perceived health was three times as high as among people in the highest income group. The prevalence of deprivation (basic, housing, social) increased with decreasing income to approximately 50-60% in the lowest income group. A substantial part of the increased health risks of the lowest income groups could statistically be accounted for by the higher prevalence of deprivation in these groups. The components that are likely to influence health indirectly, through a psychological or behavioural mechanism, accounted for most of the effect.ConclusionsThese analyses provide evidence to suggest that a low income has detrimental health effects through relative deprivation. Moreover, the results indicate an indirect link between deprivation and health problems involving psychological or behavioural factors.

AB - Study objectiveAlthough it has frequently been suggested that income affects health, there is hardly any research in which this issue has been explored directly. The aim of this study was, firstly, to examine whether income is independently associated with health, secondly, to assess the extent to which this association reflects high levels of deprivation in low income groups, and thirdly, to examine which specific components of deprivation contribute most to the link between income and health. Health indicators used were the prevalence of chronic conditions, health complaints and less than "good" perceived general health.SettingRegion in the south east of the Netherlands.ParticipantsA population of 2567 men and women who participated in an oral interview, aged 15-74.DesignData were obtained from the baseline of a prospective cohort study aimed at the explanation of socioeconomic inequalities in health.ResultsLarge inequalities in health by (equivalent) income after differences in other socioeconomic indicators had been controlled for were observed. For example, among those in the lowest income group the risk of bad perceived health was three times as high as among people in the highest income group. The prevalence of deprivation (basic, housing, social) increased with decreasing income to approximately 50-60% in the lowest income group. A substantial part of the increased health risks of the lowest income groups could statistically be accounted for by the higher prevalence of deprivation in these groups. The components that are likely to influence health indirectly, through a psychological or behavioural mechanism, accounted for most of the effect.ConclusionsThese analyses provide evidence to suggest that a low income has detrimental health effects through relative deprivation. Moreover, the results indicate an indirect link between deprivation and health problems involving psychological or behavioural factors.

KW - SOCIOECONOMIC INEQUALITIES

KW - POVERTY

KW - MORTALITY

KW - DIFFERENTIALS

KW - EXPLANATION

KW - ENGLAND

U2 - 10.1136/jech.52.9.548

DO - 10.1136/jech.52.9.548

M3 - Article

VL - 52

SP - 548

EP - 557

JO - Journal of Epidemiology and Community Health

JF - Journal of Epidemiology and Community Health

SN - 0143-005X

IS - 9

ER -