Do the Chinese “Keep up with the Jones”?: Implications of peer effects, growing economic disparities and relative deprivation on health outcomes among older adults in China

What are the health effects of unequal economic growth? What are the health consequences of 'keeping up with the Jones'? Many developed countries (e.g., US and Japan) have experienced significant income growth between 1950s and 2000s but population survey shows that on average the population is not growing more satisfied with life. Theories that attempt to respond to these findings hypothesize that as income grows, people may spend more on conspicuous consumption because they compare themselves with others in their peer groups and care about their position in socio-economic distributions relative to others. Indeed, public health studies have found a relationship between income inequality and adult health outcomes in developed countries. Specifically, there seems to be a correlation between social hierarchy and mortality, as well as a correlation between social hierarchy and morbidity.China is a prime study site due to its growing spatial inequalities in the past decade. Though China has been committed to economic reform, different regions and cities have encountered very disparate rates of development and growth. In this paper, we utilize a set of panel data collected in China (China Health and Nutrition Survey 1989-2004) to examine the effects of peer groups, relative deprivation, and income disparities on individual health outcomes such as the probability of high waist circumference, body mass index categories, probability of hypertension, nutritional intake as well as health behavior such as smoking. We use a combination of multi-level mixed effects modeling as well as factor analysis to examine these effects and find significant and differential effects of income quartiles, peer groups, relative deprivation, and Gini coefficient on health.