Gravelle Hugh, Sutton Matt
National Primary Care Research and Development Centre, Centre for Health Economics, University of York, York, UK.
Health Econ. 2009 Feb;18(2):125-45. doi: 10.1002/hec.1354.
We test the relative income hypothesis that an individual's health depends on the distribution of income in a reference group, as well as on the income of the individual. We use data on 231 208 individuals in Great Britain from 19 rounds of the General Household Survey between 1979 and 2000. Results are insensitive to the measure of self-assessed health used but the sign and significance of the effect of relative income depend on the reference group (national or regional) and the measure of relative income (Gini coefficient, absolute or proportional difference from the reference group mean, Yitzhaki absolute and proportional relative deprivation and affluence). Only one model (relative deprivation measured as income proportional to regional mean income) performs better than the model without relative income and has a positive estimated effect of absolute income on health. In this model the increase in the probability of good health from a ceteris paribus reduction in relative deprivation from the upper quartile to zero is 0.010, whereas an increase in income from the lower to the upper quartile increases the probability by 0.056. While our results provide only very weak support for the relative deprivation hypothesis, the inevitable correlation of measures of individual income and relative deprivation measured by comparing income and incomes in a reference group makes identification of the separate effects of income and relative deprivation problematic.
我们检验了相对收入假说，即个体的健康状况不仅取决于其个人收入，还取决于参照群体中的收入分配情况。我们使用了1979年至2000年间英国19轮综合住户调查中231208名个体的数据。研究结果对所使用的自我评估健康指标不敏感，但相对收入效应的符号和显著性取决于参照群体（全国性或地区性）以及相对收入的衡量指标（基尼系数、与参照群体均值的绝对或比例差异、伊茨哈基绝对和比例相对剥夺与富裕程度）。只有一个模型（相对剥夺以与地区平均收入成比例的收入来衡量）比没有相对收入的模型表现更好，并且绝对收入对健康有正向估计效应。在这个模型中，在其他条件不变的情况下，相对剥夺从四分位数上限降至零，健康状况良好的概率增加0.010，而收入从四分位数下限升至上限，概率增加0.056。虽然我们的结果仅为相对剥夺假说提供了非常微弱的支持，但通过比较个人收入与参照群体收入来衡量的个人收入和相对剥夺指标之间不可避免的相关性，使得识别收入和相对剥夺的单独效应存在问题。
