On the importance of internalized consumption norms for ill health

Aim: Relative deprivation has in previous studies been put forward as a possible mechanism in the income and health relation. To capture the importance of social comparisons analytically has been problematic due to the difficulty in identifying reference groups of significance for the individual. The authors suggest that using the individual's own preferences, arguing these to be preferences of both society and reference groups internalized by the individual, may partly bridge this problem. Methods: The study is based on the Swedish Survey of Living Conditions 1998 including a list of 37 consumption items and activities. By counting the items that the individual cannot afford, but at the same time considers to be a necessity and something that all adults should afford, a measure of self-rated deprivation (SRD) is constructed. The outcome measure used is less than good self-rated health and limiting longstanding illness. Men and women aged 25-64 years are included. Results: Over the different groups of self-rated deprivation a clear gradient in ill health, for both health measures, was found among women. The results for men seemed to dichotomize between non-deprived and those deprived on at least one item. The logistic regression models showed that even after adjusting for socioeconomic group and cash margin, there was a significant effect of self-rated deprivation. Conclusions: A significant relation was found between self rated deprivation and ill health, both less than good health and limiting longstanding illness. Self-rated deprivation had a stronger impact on women than men.