Relative deprivation and its association with health indicators: Lower inequality may not improve health

Abstract

This study tested the hypothesis of relative deprivation (RD) to investigate how inequality is associated with health and health related behaviors in a developing country context. Data from two nationally representative surveys in 2010, 2012, and 2014 were used to estimate logit and ordered logit models stratified by sex. RD was calculated based on both income and education, unlike most studies in the earlier literature that relied only on income. All results of the study were found to be robust to alternative reference groups. First, consistent with the earlier literature, RD was found to be positively correlated with indicators of poor health. Secondly, and more interestingly, unlike the results in the earlier RD literature, women with more income or education (and lower RD) were found to be more likely to be current smokers and more likely to consume a higher number of cigarettes. The main policy implication is that reducing inequality can help improve self-rated health indicators, but it will not be sufficient to achieve health policy goals. Unless smoking patterns change, reducing inequalities in income or education among women will not necessarily lead to better health; because smoking is more common among better educated and richer women.