Monica Pberg Yngwe, Chess, Stockholm University

2009-2014

Gender differences in economic resources, health and mortality - the role of social comparisons, preferences and relative deprivation.
Previous studies have shown that economic resources are of great importance for health and mortality, but also find that this relationship is different for men and women respectively. The purpose of this project has been to, with these previously identified relationships as a starting point, study how social comparisons, preferences and relative deprivation affects health and mortality for men and women in different phases of the lifecycle. The project was formulated as consisting of two parts. Part 1 applies to study the relationship between relative deprivation at the individual level and self-rated health and mortality, and it is in this part that the bulk of the project work was conducted. Project Part 2 could not be carried out in accordance with the application. The material that would be the basis for some of these analyzes, which we planned to collect as part of a project funded by the Swedish Research Council, could not be implemented as planned. We intended instead to use Living Survey 2010 to answer some of our questions about preferences and reference groups. This data set did not project provided within the project period. We therefore decided to expand the project part 1.

The project's three most important results:
1) the importance of relative income (relative deprivation): Relative income is being discussed as a possible mechanism for the relation income and health. The basic idea is that social comparisons between the individual's economic resources and resources of his/her reference group is of importance for the health of the individual, over and above the effect on health of increasing resources and opportunities that come with a higher income. In one study, we analyzed the role of relative deprivation, to experience themselves as poor relative to comparable others, for mortality (all causes) in Sweden. Previous studies have shown this, but in contexts with greater income inequality, which means that the distance between the individual's actual resources is greater. The Swedish context, which is characterized by relatively small differences in income and equality, together with the large data sets available to us provides a unique opportunity for in-depth analyzes of this potential mechanism.
The results showed that in addition to the effect of absolute income, we also find in Sweden that relative income, here measured by the Yitzhaki index, is related to mortality. Yitzhaki index summarizes the cumulative difference between the individual's income and all with a higher income in the reference group. The results showed relative deprivation measured in this way to be significantly related to mortality. The study showed a stronger relationship for men than for women. Analyzing the relationship for different income levels showed a very low impact among those within the lowest income quintile.

2) Trends in income-related inequalities in mortality: Even in countries with more extensive welfare system health inequalities have persisted or even increased over the last two decades. In one study, we evaluated trends in income-related mortality (all causes) in Sweden from the early 1990s to 2007. Results for men showed that the mortality rate fell by 29.5% in the highest income quintile (highest 20% of the income distribution), but only 6.6% at the lowest. Among women mortality decreased by 34.8% in the highest quintile, but in the lowest income group for women mortality instead increased with 22.6%. The conclusion of the study is that income-related inequality among men and women of working age in Sweden has increased since the 1990s.

3) The relationship between economic resources and health among adults has been studied extensively over the past decades. We studied the relationship between family financial hardship and self-reported health problems among young people with regard to the meaning of their own financial resources. The results showed that the relationship between family finances and self-reported ill health were largely explained by their own financial resources. Three measures of young people's own absolute and relative resources used, where possible "to not be able to buy the others have" proved associated with health problems for both sexes and all age groups.
New research questions generated:
The project has significantly contributed to a better understanding of the relative importance of the revenue and the impact of social comparison processes influence. This in turn has generated new questions concerning social comparisons and how these are affected by context and values. We continue to work with trends in income-related inequalities in health and mortality, with a greater focus on specific causes of death.

The project's international presence:
Much of the project work was done in close collaboration with Associate Professor Naoki Kondo, Tokyo University. Kondo was previously a post-doc at Harvard University, working with Professor Ichiro Kawachi, who is a very prominent researchers in the field and co-author of one of this project's articles. Project papers have been / are scheduled to be published in English in peer-reviewed journals of international circulation.

The project's two main publications:
Åberg Yngwe M., Kondo N., Hägg S. and Kawachi I. Relative deprivation and mortality - a longitudinal study in a Swedish population of 4.7 million, from 1990 to 2006. BMC Public Health 2012; 12:664
Åberg Yngwe M. and Östberg V. The family's economic resources and adolescents 'health complaints - do adolescents' own economic resources matter? European Journal of Public Health 2012; 23:24

The project's publishing strategy:
We have aimed to publish articles open access. Two of the studies were published in BMC Public Health, an open access journal. For the studies in the process of being completed, we will also see where the ability to publish open access.

Publikationslista och pågående arbete:
 
Åberg Yngwe M., Kondo N., Hägg S. and Kawachi I. Relative deprivation and mortality – a longitudinal study in a Swedish population of 4.7 million, 1990-2006. BMC Public Health 2012;12:664

Åberg Yngwe M. and Östberg V. The family’s economic resources and adolescents’ health complaints – do adolescents’ own economic resources matter? European Journal of Public Health 2012;23:24

Bergqvist K., Åberg Yngwe M. and Lundberg O. Understanding the role of welfare state characteristics for health and inequalities – an analytical review. BMC Public Health 2013;13:1234

Kondo N., Rostila M. and Åberg Yngwe M. Rising inequality in mortality among working-age men and women since the early 1990s in Sweden: a national registry-based repeated cohort study. (revised and re-submitted, Journal of Epidemiology and Community Health)

Miething A. and Åberg Yngwe M. Persistence and variability in income: exploring their role in self-rated health in Swedish survey data (submitted)

Kondo N., Rostila M and Åberg Yngwe M.  Increasing trends in suicide mortality of working-age men and women during and after the early-1990s economic recession in Sweden: a national registry-based repeated cohort study. (manus, konferenspresentation)

Åberg Yngwe M, Lundberg O. Gender differences in the importance of relative deprivation for mortality in Sweden. (manus)

Bergqvist K., Åberg Yngwe M. and Miething A. The role of income satisfaction in the income and health relationship – a comparative study (pågående)