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Relative Deprivation and Mental Health

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14 diapositives · 328 Views · Sep 03, 2014

Relative Deprivation and Mental Health. Christine Eibner Roland Sturm Carole Gresenz RAND Corporation. Background. Continuous socioeconomic gradient in mental health (Sturm and Gresenz, 2002) Possible Causes: Poverty Low income Relative deprivation. Relative Deprivation (RD).

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  1. Relative Deprivation and Mental Health Christine Eibner Roland Sturm Carole Gresenz RAND Corporation

  2. Background • Continuous socioeconomic gradient in mental health (Sturm and Gresenz, 2002) • Possible Causes: • Poverty • Low income • Relative deprivation

  3. Relative Deprivation (RD) • Low income relative to a reference group affects health. • Difference between own income (yi) and the average reference group income given that income is greater than yi. • Individual-level measure. • Runciman (1966), Yitzhaki (1979).

  4. RD vs. Low Income/Inequality • RD depends on the incomes of others. • Richer reference group, higher RD. • RD is an upward-looking, individual measure. • Inequality is the same for entire reference group; describes distribution of income. • RD describes an individual’s standing; different for each member of the reference group.

  5. Contributions • Explore various definitions of reference group: • Area (Super-PUMA) • Age • Sex • Marital Status • Reference group income distribution based on 2000 Census.

  6. Contributions • Healthcare for Communities (HCC) Data: • Restricted use version; identifies location. • Common mental health disorders assessed using screeners (CIDI-SF). • Continuous income, not broad categories.

  7. Sample Characteristics

  8. Examples of Relative Deprivation,Reference group is Super-PUMA and Age

  9. Baseline Model • Logistic regression with reference group random effect. • Dependent variables: depression, anxiety/panic, any probably mental health disorder. • Control variables: income, age, sex, education, marital status, # in family, race/ethnicity, HCC wave, super-PUMA of residence.

  10. Results: Yitzhaki-based RD MeasureReference Group is Super-PUMA, Age, Sex

  11. Other Outcomes (Reference Group is Super-PUMA, Age, and Sex).

  12. Summary • Relative deprivation is correlated with worse mental health. • Reference group definition is important. No effect when geography alone is considered. • Results strongest when age is a component of reference group.

  13. Limitations • Only one measure of relative deprivation. • Super-PUMAs are large relative to neighborhoods. • Causality?

  14. Implications • Rather than focus on community factors, we may want to focus on reference groups. • Relative deprivation argument might help to inform: • Socioeconomic gradient in health. • Aggregate-level correlations between income inequality and health.