Relative deprivation and mortality in South Africa

This paper tests the relative income hypothesis by considering the relationship between mortality, income and relative deprivation in South Africa using individual-level data on income and five measures of relative deprivation each with a different reference group. We find that income tends to be protective of, and relative deprivation detrimental to health, but the latter often gives a better account of mortality than does income alone. For some population groups the fit is improved in specifications which include both income and relative deprivation. Overall, there seems to be solid evidence in support of the relative income hypothesis, particularly for the more economically disadvantaged population groups. Relative deprivation is especially significant when age is the reference group, suggesting that the comparison of socio-economic standing that has an impact on health tends to happen within cohorts. The results are robust to splitting the sample into urban/rural subsamples and to looking at the incidence of illness as the health outcome rather than mortality. While little is known about the mechanisms underlying the effect of relative deprivation on health and mortality, the consistent evidence in favor of age as a reference group, particularly in a context like South Africa's suggests that intra-cohort comparisons should be an avenue for more in depth investigation.