Vol.:(0123456789) 1 3 Quality of Life Research https://doi.org/10.1007/s11136-018-1863-y Deprivation is associated with worse physical and mental health beyond income poverty: a population-based household survey among Chinese adults Roger Yat‑Nork Chung 1  · Gary Ka‑Ki Chung 1  · David Gordon 2  · Samuel Yeung‑Shan Wong 1  · Dicken Chan 1  · Maggie Ka‑Wai Lau 3  · Vera Mun‑Yu Tang 3  · Hung Wong 4 Accepted: 25 April 2018 © Springer International Publishing AG, part of Springer Nature 2018 Abstract Purpose In studying health inequality, poverty as measured by income is frequently used; however, this omits the aspects of non-monetary resources and social barriers to achieving improved living standard. Therefore, our study aimed to examine the associations of individual-level deprivation of material and social necessities with general physical and mental health beyond that of income poverty. Methods A territory-wide two-stage stratifed random sample of 2282 community-dwelling Hong Kong adults was surveyed between 2014 and 2015. Income poverty and a Deprivation Index were used as the main independent variables. General health was assessed using the validated 12-item Short-Form Health Survey version 2, from which physical component sum- mary and mental component summary were derived. Results Our results in multivariable ordinal logistic regressions consistently showed that, after adjusting for income pov- erty, socio-demographic and lifestyle factors, being deprived was signifcantly associated with worse physical (OR 1.66; CI 1.25–2.20) and mental health (OR 1.83; CI 1.43–2.35). Being income poor was also signifcantly associated with worse mental health (OR 1.63; CI 1.28–2.09) but only marginally with physical health (OR 1.34; CI 1.00–1.80) after adjustments. Conclusions Income does not capture all aspects of poverty that are associated with adverse health outcomes. Deprivation of non-monetary resources has an independent efect on general health above and beyond the efect of income poverty. Policies should move beyond endowment and take into account the multidimensionality of poverty, in order to address the problem of health inequality. Keywords Deprivation · Poverty · Physical health · Mental health · Chinese adults · Hong Kong Introduction Health inequality has become a burgeoning feld of research especially in the Western world [1]. A major feld of health inequality research focuses on the efects of poverty on health that poorer people around the world tend to have worse health outcomes than the better of. Substantial evidence supports that health inequality arises from inequalities in money, resources and power; therefore, achieving equitable distribu- tion of social determinants of health, both across the life course and in wider societal and economic levels, is the key to reduc- ing health inequality [2]. While the association between pov- erty and health is generally regarded as bilateral and dynamic [3], a growing number of studies focused on understanding the underlying mechanisms, particularly the materialistic and psychosocial mechanisms [1]. However, limited studies about Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11136-018-1863-y) contains supplementary material, which is available to authorized users. * Roger Yat-Nork Chung rychung@cuhk.edu.hk 1 JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China 2 School for Policy Studies, University of Bristol, Bristol, UK 3 Asia-Pacifc Institute of Ageing Studies, Lingnan University, Hong Kong, China 4 Department of Social Work, The Chinese University of Hong Kong, Hong Kong, China