Relative deprivation in income and self-rated health in the United States

Absolute income is robustly associated with health status. Few studies have, however, examined if relative income is independently associated with health. We examined if, over and above the effects of absolute income, individual relative deprivation in income as well as position in the income hierarchy is associated with individual poor health in the U.S. Using three rounds of the Current Population Surveys (CPS), we analyzed the association between self-rated health (1 = fair/poor, 0 = otherwise) and the Yitzhaki index of relative deprivation in income and percentile position in the income hierarchy across 17 reference groups. Over and above the effects of absolute income, the odds ratio for reporting poor health among individuals in the highest quintile of relative deprivation compared to the lowest quintile ranged between 2.18 and 3.30, depending on the reference groups used. A 10 percentile increase in income position within reference groups was associated with an odds ratio of poor health of 0.89. Relative deprivation appeared to explain between 33 and 94% of the association between individual income and self-rated health. Relative deprivation in income is independently associated with poor health over and above the well established effects of absolute income on health. Relative deprivation may partly explain the association between income inequality and worse population health status.