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Relative Deprivation and Mental Health

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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Relative Deprivation and Mental Health

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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.

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