【公共衛生系列 -- 長達七年的研究終有成果！】我與Prof Samuel Wong、黃洪教授、我的博士學生及研究團隊的一篇有關貧窮與健康的文章在學術期刊"Quality of Life Research" (【生活質素研究】) 面世！我們將會從這研究項目出版一連串的研究結果，而這是打頭陣的第一篇。
My new academic paper on poverty and health has been published! After 7 years of hard work for this longitudinal study with Prof Samuel Wong, Prof Wong Hung, My PhD student Gary Chung and other research teammates, this is the first paper that comes out from the study!
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標題：匱乏貧窮與較差的身心健康有顯著關係：以人口為基礎的香港家庭調查
摘要
目的：雖然很多研究經常以收入來定義貧窮，但這實際上忽略了非金錢的資源及社會障礙對生活水平帶來的影響。有見及此，我們這個研究針對去測試在個人層面上對於物質及社會必需品的匱乏（而不只是收入貧窮）與一般身心健康之間的關係。
方法：2014至2015年間，我們以兩階段分層樣本方式隨機抽出2,282位居住在香港社區的成人。我們以收入貧窮與匱乏貧窮作為模型的主要自變數（即風險因素），而我們使用SF-12第二版來量度一般身心健康。
結果：我們的多分類順序變項邏輯迴歸模型顯示出，就算調整了收入貧窮、社會人口因素及生活方式後，匱乏貧窮與較差的身體健康（勝算比=1.66; 置信區間=1.25-2.20）及心理健康 （勝算比=1.83; 置信區間=1.43-2.35）仍然有顯著關係。而調整了匱乏貧窮、社會人口因素及生活方式後，收入貧窮與較差的心理健康（勝算比=1.63; 置信區間=1.28-2.09）仍然有顯著關係，但與較差的身體健康則只有邊緣關係（勝算比=1.34; 置信區間= 1.00-1.80）。
結論：收入未能解釋所有貧窮對於較差健康的影響，而對於物質及社會必需品的匱乏在收入貧窮之上也與較差的身心健康有顯著關係。政策不應該只集中派錢形式，而是需要考慮到貧窮的多元性（即包括金錢與非金錢的匱乏）來處理貧富之間的健康不平等問題。
Title: Deprivation is associated with worse physical and mental health beyond income poverty: a population-based household survey among Chinese adults.
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 stratified 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 summary and mental component summary were derived.
RESULTS:
Our results in multivariable ordinal logistic regressions consistently showed that, after adjusting for income poverty, socio-demographic and lifestyle factors, being deprived was significantly 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 significantly 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 effect on general health above and beyond the effect 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.
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