How do perceived changes in inequality affect health?

Perceived Social Mobility and Smartphone Dependence in University Students: The Roles of Hope and Family Socioeconomic Status

Purpose

Drawing upon the cognitive-behavioral model of pathological Internet use (PIU) and tunnel effect, this study aimed to construct a moderated mediation model from the perspective of social ecology. Specifically, the model investigated the relationship between perceived social mobility and smartphone dependence, with a focus on the mediating role of hope and the moderating effect of family socioeconomic status (SES) underlying this relationship.

Methods

A cross-sectional study was conducted with 718 Chinese university students (Mage = 19.19, 70.2% female) from Beijing, Henan, and Tianjin, who anonymously filled out the Perceptions of Socioeconomic Mobility Scale, Mobile Phone Addiction Index Scale, Openness to the Future Scale, and family socioeconomic status questionnaire. Preliminary data analysis was executed using SPSS 22.0, and the moderated mediation effect was tested using the latent moderated structural equations approach in Mplus 8.3.

Results

The results showed that (a) less perceived social mobility was linked with greater smartphone dependence; (b) hope mediated the aforementioned relationship; and (c) family SES moderated the first-stage path of the indirect effect through hope. For university students with low (rather than high) family SES, their level of hope increased with the improvement of perceived social mobility, and in turn, that of smartphone dependence decreased.

Conclusion

These findings suggest that positive perceptions of upward social class mobility and hopeful attitudes toward future opportunities and personal development among disadvantaged university students may alleviate their reliance on smartphones. Researchers and policymakers should pay attention to the role of individuals' perceptions of the macro environment in motivating specific risky behaviors among university students. Future interventions are essential to mitigate pessimistic environmental perceptions and foster a sense of hope among university students.

A longitudinal study of perceived social position and health-related quality of life

BACKGROUND

A large body of evidence suggests that there is a social gradient in the association between perceived social position and various health outcomes. Yet only a fraction of this research uses longitudinal data, and these studies usually rely on two data points in time, consider a single health outcome measure, overlook non-linear effects of perceived social position, and come almost exclusively from the Western welfare democracies.

METHODS

Using data for 1921 individuals from three waves (2008, 2013, 2018) of the Polish Panel Survey (POLPAN), we fit between- and within-individuals hybrid-effects models with cluster-robust standard errors to investigate the association between one's perceived social position (self-placement on a socioeconomic hierarchy scale varying 1 to 10) and subsequent health-related quality of life (HRQoL) measured using the Nottingham Health Profile (NHP) and its six components.

RESULTS

We find that the association between perceived social position and health-related quality of life is larger when estimated between individuals than within individuals, yet in fixed- and hybrid-effects models perceived social position remains significantly and negatively linked with both the aggregated NHP measure as well as with its components such as emotional reaction, physical abilities, sleep, and social isolation. We also identify that starting to perceive oneself at the lower end of the social hierarchy is associated with a deteriorating health-related quality of life but a change at the top of the perceived social hierarchy is not linked with an improvement in NHP scores.

CONCLUSIONS

We provide new evidence on the significant and non-linear links between perceived social position and health-related quality of life and highlight possible pathways linking these two aspects of individuals' lives.

Socioeconomic differences in the perception of inequalities in healthcare utilization and health in South Korea

This study investigated the lay perception of inequalities in society, healthcare utilization, and health in Korea. We also examined the association between socioeconomic status (SES) and perception of inequalities. Data from an online survey on the perception of health and healthcare inequalities related to cancer conducted between October 19, 2021, and November 12, 2021, were used. Data of 3,769 participants aged 20 to 74 years from 17 provinces were analyzed. We examined the perceived level of inequalities according to SES or residential area using frequency analysis, a t-test or analysis of variance (ANOVA), multiple linear regression analysis, and multiple logistic regression analysis. The mean score for perception of social inequality was 5.99 [Standard Deviation (SD) = 1.95] and that for perception of healthcare utilization inequality was 4.75 (SD = 1.96). The perception rate of health inequality according to SES and residential area was approximately 59 % and 61 %, respectively. Higher the income level, lower the level of perception of social inequalities β = -0.22, p < 0.01). Higher the education level, higher the level of perception of healthcare utilization inequalities (β = 0.21, p < 0.01). Higher the education level, higher the level of perception of health inequalities according to SES or residential area [adjusted odds ratio (aOR): 2.33 (95 % CI: 1.48, 3.66); aOR: 2.73 (95 % CI: 1.73, 4.31)]. Socioeconomic inequalities were observed in the perception of inequalities in healthcare utilization and health. Policymakers should establish policies to bridge the gap between perceived healthcare utilization inequalities and health inequalities. Future research should investigate the perception of healthcare utilization and health inequalities.

On the lowest rung of the ladder: How social exclusion, perceived economic inequality and stigma increase homeless people's resignation

Despite the relevance of social exclusion and economic inequality for homelessness, empirical studies investigating how these issues relate to homeless people's psychological well-being are scarce. We aimed to fill this gap by conducting two quasi-experimental studies on homeless and non-homeless groups. The first study (N = 200) showed that homeless (vs. non-homeless) people presented higher levels of resignation, characterized by depression, alienation, helplessness, and unworthiness (Williams, 2009). The second study (N = 183) replicated the findings from Study 1 and showed that perceived economic inequality could increase homeless people's resignation by emphasizing perceptions of social exclusion. Additional analyses found that identification with the stigmatized homeless group could mediate the relationship between perceived inequality and social exclusion, increasing the resignation. Overall, the results showed that chronic social exclusion of homeless people is associated with higher levels of resignation. Moreover, they showed the role of perceived economic inequality and homeless group stigmatized identification as group-specific mechanisms favouring social exclusion and ultimately worsening psychological well-being.

Economic development, intergenerational mobility, and health in South Korea

A growing number of studies reported the association between social mobility and health. However, few studies investigated whether the association varies by age group. Drawing on the economic environment that facilitated social mobility in South Korea, we postulate each age group had a different extent of social mobility, which would vary with the extent of economic growth and affect the association between social mobility and health. We used data from KDI National Happiness Survey 2018 and measured perceived mobility using respondents' perceived social position and their parents' social position. We examined whether social mobility was associated with self-rated health and psychological well-being. The upwardly mobile individuals were more likely than the stable ones to report 'happy'. Such a positive association between upward mobility and happiness was consistently found when the sample was restricted to the ages 30-59 and 40-49. For self-rated health, the downwardly mobile individuals were less likely to report good health. However, no significant difference in self-rated health was found after the youngest and oldest age groups were excluded. We found that perceived social mobility was strongly associated with psychological well-being rather than self-rated health. Moreover, we found a stronger association between upward mobility and happiness among the aged 40-49, who had the largest proportion of upwardly mobile individuals and spent their adolescence during rapid economic growth. The findings underscore the importance of the economic and social context in which individuals perceive their social position and shape their well-being.

Do drivers of renewable energy consumption matter for BRICS economies? Nexus among technological innovation, environmental degradation, economic growth, and income inequality

In light of increasing concerns about climate change and energy security, renewable energy has been seen as the most promising solution to fulfil future energy needs. This study examines the drivers of renewable energy consumption (REC) and the nexus between GDP growth, technological innovation, gross fixed capital formation, CO2 emissions, income inequality, and renewable energy consumption (REC) using annual data from BRICS countries. To this end, the study uses the augmented mean group (AMG) estimator, a second-generation estimator that takes slope homogeneity and cross-sectional dependence into consideration. For robustness, the pooled mean group (PMG) estimator has also been utilized. The findings of both estimators indicate that carbon emissions, technological innovation, and gross fixed capital formation exert adverse and significant impacts on REC. The findings also show that the use of renewable energy will rise as income inequality declines. We also employ the Dumitrescu and Hurlin (DH) granger causality test. The results of the analysis demonstrate a one-way causal association between income inequality and REC. This finding confirms that a reduction in income inequality will have a major impact on the adoption of renewable energy sources.

Is the mediating effect of psychosocial stress on the income-health relationship moderated by income inequality?

Background

There now exists a rich body of literature on the relationship between income, income inequality, and health. The discussion about the impact of income and income inequality on health includes psychosocial mechanisms, such as long-term perceptions of inferiority and social positioning, material advantage from income, and the structural conditions that define what people can do with their material resources.

Aims

This study investigated the extent to which income's effects on health are mediated by psychosocial stress, and to what extent those effects are moderated by country-level income inequality and economic development.

Methods

Data were collected from The European Social Survey, round 7. Multilevel moderated mediation analysis was applied to estimate the extent of psychosocial stress mediation of the effects of income on self-rated health. Moderated parameters were estimated over country-level income inequality and economic development.

Results

Significant full or partial meditation by psychosocial stress was found in all 20 countries studied. Effects moderated by income inequality and GDP per capita showed expected relationships but failed to reach conventional levels of statistical significance.

Conclusions

Individual-level income remains important for explaining the income-health gradient in self-rated health in Europe. The income-health relationship and the extent to which it is mediated by psychosocial stress varies among countries but is not significantly moderated by contextual income or income inequality. Policies should be aimed at allowing a greater proportion of people to live in material comfort and reduced sense of financial precarity, and protecting individuals from harmful consequences of low income.

The sources of the Kuznets relationship between the COVID-19 mortality rate and economic performance

This paper discusses the findings of an empirical analysis of the Kuznets, or reverse U-shaped relationship, between the COVID-19 mortality rate and economic performance. In the early stages of economic development, the COVID-19 mortality rate is anticipated to rise with rising economic activity and urbanization. Eventually, the mortality rate decreases at higher economic development levels as people and the government are more capable of investing in disease abatement measures. The quality of political institutions, wealth distribution, urbanization, vaccination rate, and improvements in healthcare systems are hypothesized to affect the COVID-19 mortality rate. Examining this relationship can be effective in understanding the change in the COVID-19 mortality rate at different economic performance stages and in identifying appropriate preventive measures. This study employed the negative binomial regression to model a cross-sectional dataset of 137 countries. Results indicated that the relationship between the per-head gross domestic product (GDP) level and the COVID-19 mortality rate appeared to follow a pattern like the Kuznets curve, implying that changes in institutional quality, healthcare advancements, wealth distribution, urbanization, vaccination rate, and the percentage of the elderly population were significant in explaining the relationship. Improvement of the healthcare system has a notable effect on lowering the COVID-19 mortality rate under more effective government conditions. Additionally, the results suggested that a higher per-head GDP is required to reverse the rising trend of the mortality rate under higher income inequality. Based on these results, preventive measures, and policies to reduce COVID-19 mortalities were recommended in the conclusion section.

Information About Inequality of Opportunity Increases Downward Mobility Perceptions: A Population-Wide Randomized Survey Experiment

Existing evidence which is primarily based on cross-sectional and observational data suggests that perceptions of doing worse or better than parents might be more important for various life outcomes than the conventional measures of mobility based on the objective indicators of socioeconomic position. In 2021, we commissioned a nationally representative survey in Georgia which included a population-wide randomized survey experiment. We confirmed the association between, on the one hand, perceived social mobility and, on the other hand, physical and mental health, satisfaction with life, and the perceived state of affairs in the country. More importantly, the experimental design allowed us to conclude that the perception of being downwardly mobile was causally determined by a short message shared with individuals that equality of opportunity in their country was low. Those who were given information that children's socioeconomic position was strongly linked to their parents' socioeconomic position were seven percentage points more likely than individuals in the control group to perceive themselves as being downwardly mobile. We extrapolate these findings to the broader context and argue that the messages about (in)equality of opportunity which individuals receive in their everyday lives might also shape their perceptions of social mobility in other countries.

Health Outcomes, Income and Income Inequality: Revisiting the Empirical Relationship

In this paper we revisit the relationship between health outcomes, income, and income inequality by applying alternative panel methodologies to a dataset of high-income countries spanning the time period 1980-2017. In this direction, we adopt alternative methodological frameworks in order to provide a) meaningful results by taking into account standard errors that alleviate problems of cross-sectional (spatial) and temporal dependence, and b) insights into the underlying relationships at several points of the conditional distribution of the health outcomes dependent variables. The evidence strongly supports the significant role that income plays in determining health outcomes. The findings relating to income inequality and nonlinear terms are more fragmented in that their significance and sign-direction depend on the functional form and the respective quantiles of the distribution the relationships are evaluated.

Social Mobility, Health and Wellbeing in Poland

Recently there has been a surge of interest in the consequences of intergenerational social mobility on individuals' health and wellbeing outcomes. However, studies on the effects of social mobility on health, using high-quality panel survey data, have almost exclusively been conducted in Western welfare democracies. To account for this gap, and using empirical data from one of the largest and most eventful post-communist countries, Poland, in this study we investigate how individuals' origin and destination socio-economic position and social mobility are linked to self-rated health and reported psychological wellbeing. We use the Polish Panel Survey (POLPAN) data to construct self-rated health and psychological wellbeing measures, origin, destination and occupational class mobility variables, and account for an extensive set of sociodemographic determinants of health. We employ diagonal reference models to distinguish social mobility effects from origin and destination effects, and account for possible health selection mechanisms. Our results suggest that there is an occupational class gradient in health in Poland and that both parental and own occupational class matter for individual health outcomes. We also find a positive reported psychological wellbeing effect for upward social mobility from the working to the professional class.

How democracy alters our view of inequality - and what it means for our health

BACKGROUND

Income inequality is associated with poor health when economic disparities are especially salient. Yet, political institutions may alter this relationship because democracies (as opposed to autocracies) may be more inclined to frame inequalities in negative rather than positive ways. Living in a particular political system potentially alters the messages individuals receive about whether inequality is large or small, good or bad, and this, in turn, might affect whether beliefs about inequality influence health. Further, media coverage of economic inequality may negatively affect health if it contributes toward the general perception that the gap between rich and poor has gone up, even if there has been no change in income differentials.

METHODS

In this study, we explore the relationship between democracy, perceptions of inequality, and self-rated health across 28 post-communist countries using survey and macro-level data, multilevel regression models, and inverse probability weighting to estimate the average treatment effect on the treated.

RESULTS

We find that self-rated health is higher in more democratic countries and lower among people who believe that inequality has risen in the last few years. Moreover, we observe that people in democracies are more likely to learn about rising inequality through watching television and that when they do it has a more harmful effect on their health than when people in autocracies learn about rising inequality through the same channel, suggesting that in countries where there is less trust in the television media learning about rising inequality is not as harmful for health.

CONCLUSIONS

Our results indicate that while democracies are generally good for well-being, they may not be unambiguously positive for health. This does not mean, of course, that inequality is good for health nor that, on average, autocracies have better health than democracies; but rather that being more aware of inequality can negatively affect self-rated health.

BMI and dissatisfaction with life: contextual factors and socioemotional costs of obesity

Purpose

In this study, we investigate whether individuals’ BMI categories are associated with being dissatisfied with one’s life, how this association is affected by the social comparison that individuals make, and what the role of the overall BMI levels in this process is.

Methods

We use data for 21,577 men and 27,415 women, collected in 2016 by the European Bank for Reconstruction and Development, from 34 countries in Europe, the Middle East, and Central Asia. To understand the moderating effect of contextual environment, we use multilevel mixed effect logistic regression models and data for national, regional, and cohort-specific BMI levels.

Result

We find that the association of BMI and dissatisfaction with life differs by gender, with overweight men being less likely to be dissatisfied with life than men with normal weight and obese women being more likely to be dissatisfied with life compared to women with normal weight. For contextual effects, we find that obese women in regions with low BMI levels are more likely to be dissatisfied with life. The effect of obesity on female life dissatisfaction is not observed in regions with high BMI levels. As for men, regional BMI levels affect the levels of life dissatisfaction but only for underweight men.

Conclusions

Our study adds additional nuance to the quality-of-life research by showing that the association between BMI and decreased life satisfaction is, at least partially, moderated by the contextual environment, and that the character of these effects differs by gender.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11136-021-02912-3.

Correlates of memory and executive function in mid-aged and older adults in the CLSA: A minority stress approach

OBJECTIVES

Maintaining cognitive function is an important component of healthy aging. There is increasing recognition that extraneous factors expedite the typical cognitive aging process. Risk factors for cognitive decline cluster around inequalities and disproportionally affect minority and vulnerable groups. Taking a minority stress approach, we examined the relationship between proxy measures of minority stress and cognitive health in a large sample of Canadians aged 45-85 years.

METHODS

Data were drawn from the baseline of the Canadian Longitudinal Study on Aging (CLSA), a prospective cohort study. Memory (n = 36,849) and executive function (n = 36,266) were assessed using standardized assessment tools. We ran multiple linear regression models with memory and executive function as the outcomes. Explanatory variables included known correlates of cognitive health (i.e., demographic, health, and cognitive reserve) and proxy measures of minority stress (i.e., sexual orientation, race, and perceived social standing).

RESULTS

Results were consistent with existing evidence showing that demographic and health variables were associated with cognitive performance. Modifiable health variables, walking and fruit/ vegetable consumption were associated with better cognitive performance, as were cognitive reserve and social support measures. Within the models, racial minority status was consistently associated with lower cognitive performance. As one's perceived social standing within their own community increased, so too did cognitive function.

DISCUSSION

These findings identify factors that may put people at risk for cognitive decline. There is a need to support the cognitive health of racialized Canadians and members of other disadvantaged groups, while promoting health equity.

Intergenerational social mobility and health in Russia: Mind over matter?

The consequences of changing one's socio-economic status over the life course-i.e. social mobility-for individual health are not well understood. Theories of the health implications of social mobility draw on the human perception of one's changing conditions, but empirical studies mostly examine the health implications of moving from objectively defined indicators of parental socio-economic position such as education, occupation, or income, to own socio-economic position in adult life. Little is known about the consequences of individuals' own assessment of changes in socio-economic position for health outcomes. In this study, we examine the association of social mobility and health in a unique sample of the Russian population after the transition to a market society. We take a broad perspective on social mobility, putting emphasis on subjectively perceived social mobility. Results show that individuals' objective characteristics only partially explain the variation in their subjective perceptions of intergenerational mobility. Net of social origin and destination variables, subjective social mobility is associated with individuals' health outcomes, as measured by the 12-Item Short Form Health Survey. Those who perceive being upwardly mobile report better health, and downward mobility is associated with poorer health. The association holds for mental and physical health, for perceived downward and upward social mobility, and for a general subjective measure of mobility and a subjective measure prompting respondents to only think of mobility in terms of occupation. These findings are robust to controlling for a rich set of socio-demographic predictors on childhood adversity, contemporaneous material wellbeing, and family-related circumstances. We conclude that a conventional focus on single socio-economic status dimensions such as occupation might be too narrow to capture the health consequences of social mobility.