Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, SE-106 91, Stockholm, Sweden.
BMC Public Health. 2012 Aug 16;12:664. doi: 10.1186/1471-2458-12-664.
Relative deprivation has previously been discussed as a possible mechanism underlying the income-health relation. The idea is that income matters to the individual's health, over and above the increased command over resources, as the basis of social comparisons between a person and his or her reference group. The following study aimed to analyze the role of individual-level relative deprivation for all-cause mortality in the Swedish population. The Swedish context, characterized by relatively small income inequalities and promoting values as egalitarianism and equality, together with a large data material provide unique possibilities for analyzing the hypothesized mechanism.
The data used are prospective longitudinal data from the Swedish population and based on a linkage of registers. Restricting selection to individuals 25-64 years, alive January 1st 1990, gave 4.7 million individuals, for whom a mortality follow-up was done over a 16-year period. The individual level relative deprivation was measured using the Yitzhaki index, calculating the accumulated shortfall between the individual's income and the income of all other's in the person's reference group. All-cause mortality was used as the outcome measure.
Relative deprivation, generated through social comparisons, is one possible mechanism within the income and health relation. The present study analyzed different types of objectively defined reference groups, all based on the idea that people compare themselves to similar others. Results show relative deprivation, when measured by the Yitzhaki index, to be significantly associated with mortality. Also, we found a stronger effect among men than among women. Analyzing the association within different income strata, the effect was shown to be weak among the poorest. Revealing the importance of relative deprivation for premature mortality, over and above the effect of absolute income, these results resemble previous findings.
Relative deprivation, based on social comparisons of income, is significantly associated with premature mortality in Sweden, over and above the effect of absolute income. Also, it was found to be more important among men, but weak among the poorest.
相对剥夺感此前被认为是收入与健康关系的一种潜在机制。其观点是，收入对个人健康很重要，这超出了个人对资源的掌控程度，因为它是个人与其参照群体进行社会比较的基础。本研究旨在分析个体层面的相对剥夺感对瑞典人群全因死亡率的作用。瑞典的社会环境特点是收入不平等程度相对较低，同时推崇平等主义和平等价值观，再加上拥有大量的数据资料，为分析假设机制提供了独特的机会。
本研究使用的是来自瑞典人群的前瞻性纵向数据，并基于登记册的链接。将选择限制在 25-64 岁、1990 年 1 月 1 日仍存活的个体中，这使得 470 万人成为研究对象，对其进行了为期 16 年的死亡率随访。使用 Yitzhaki 指数来衡量个体层面的相对剥夺感，该指数通过计算个体收入与参照群体中其他人的收入之间的累计差距来衡量。全因死亡率用作结局指标。
通过社会比较产生的相对剥夺感是收入与健康关系中的一种潜在机制。本研究分析了不同类型的客观定义参照群体，这些参照群体均基于人们与相似他人进行比较的理念。结果表明，使用 Yitzhaki 指数衡量的相对剥夺感与死亡率显著相关。此外，我们发现这种相关性在男性中比女性中更强。在不同收入阶层内分析这种相关性时，发现其在最贫困人群中的作用较弱。这些结果表明，相对剥夺感除了对绝对收入的影响外，还与过早死亡显著相关，揭示了相对剥夺感对过早死亡的重要性。
基于收入的社会比较的相对剥夺感与瑞典的过早死亡率显著相关，其作用超过了绝对收入的影响。此外，它在男性中更为重要，但在最贫困人群中作用较弱。
