The 6th Doshisha - Chung-Ang University Joint Seminar on East Asian Social Welfare“How does economic deprivation lead to problem drinking?”: The mediating effect of income inequality consciousness and depression

November 19, 2016

Chung-Ang University
Suyoung Lee, Soobi Lee (Doctoral Student)

Introduction

Household experience of poverty% income held by upper 10%*

(2011~2014년)45%
1 yr poverty

4241
32

10.2%

Yes
28.2%
No

31
222 yrs 5.8%

3 yrs 4.1%
4 yrs 8.1%

experience
71.8%

Korea **

SingaporeJapanNew Zealand Australia

Malaysia* Asian countries where data were available in 2013** Increased from 29% in 1995 (16% increase)(Source) : International Monetary FundIntergenerational transmission of poverty (Kim, 2010) à Fixation ofpoverty/economic deprivation

Introduction
Meaning of poverty in current society

Not just economic deprivation. It means deprivation of basic needs,
ability and opportunity, and sociocultural isolation

Introduction
Influence of poverty, income inequality on individual and society
Reason for suicidal thought (2015)

Depression and household income (2013)

31.5
23.0(%)

21.6(%)

14.2
8.0

9.6

Psychiatricfinancial

physicalfamily

4.2

4.2

4.1

work

othersunknown

lower 25%

upper 25%

Economic hardship and increasing inequality is being manifested in many
aspects of social problems

income inequality and alcohol use (2005-2013)
2.Poverty,연구목적
Drinking behaviors by Income Group

82.7

8.6

82.1

19.6

77.7
75.0

low

alcohol dependencehigh risk drinking

Drinking rate

mid-low mid-high

high

low

17.4

7.9

7.5

17.5

14.6

mid-low mid-high

low

high

mid-low mid-high

6.5

high

※ source : Ministry of Health and Welfare (2011). National Health Statistics.

Changes in Hazardous drinking, Alcohol dependence rate by Income group (2005-2011)25drinking rate(income)2005

Hazardous drinking(high)

14.3

Hazardous drinking
(low)

16.1

2007

2011

Hazardous drinking

20

17.3
17.5

17.5
19.6

Alcohol dependence(high)

7.8

6.3

6.5

Alcohol dependence
(low)

7.4

6.8

8.6

(high)
Hazardous drinking

15(low)

10

Alcohol dependence

5

Alcohol dependence(high)

(low)

0
2005

20072011

on poverty, income inequality and alcohol problems
2.Literature연구목적
1/3 of those in the lower income group (receiving basic livelihood benefit) havealcohol-related problems (Do & Hong, 2014)
The poverty group showed faster increase in problem drinking over the 4 years.
Also, people with higher perception of income inequality showed faster increasein problem drinking (Chung & Lee, 2015)
Material hardship (economic deprivation) in the lower income group leads todrinking behavior and increases the risk of alcohol problems (Lee & Lee, 2016)
Lower perception of subjective class is related to higher level of stress, whichleads to alcohol related problems (Hwang & Chung, 2016)

Richard Wilkinson (2005)
Income inequality à wider gap in social status à depression, stress, aggression, anxiety
increase à health problems (including alcohol and drug abuse)Process of social stress (Aneshensel et al., 1991; Turner et al., 1995; Pearlin, 1999)
The poor experiences social stress from negative life events coming fromdeprivation in basic clothing/shelter, education, health, social activities
Clothing

Negative emotions related to relationshipproblems and social pressure can lead toalcohol consumption

and shelter

Socialactivities

Negativelife-event

Health

Education

People with limited resources have limited
ways to cope with stressEasy access to alcohol in Korea à makes
easier to use alcohol to cope with stressTheoretical background
Relationship between psychological vulnerability and problem
drinking has been studied extensively.

micro

macro

Emotional
factors
Depression
StressSocioeconomic
factors
Economic
deprivation
Income inequality

However, the influenceof macro socioeconomic
factors has received lessattention.

Need to understand the influence of socioeconomic factors on alcohol use(and examine the path of such influence)Study objective
This study aims toExamine the path of how economic deprivation influences problemdrinking

Research questions• What is the relationship between economic deprivation, perceived income
inequality, depressive mood, and problem drinking• How does economic deprivation influence problem drinking?

Methods
Data
The Korean Welfare Panel, 8th wave (2013)

Study participants
13,553 adults (20+)

Analytical method
Path analysis
SPSS / AMOS

Main variables
Problem drinking (AUDIT), Experience of Economic deprivation,Perceived income inequality, depressive mood (CES-D)

Methods
Operational definition of variables
Problem drinking: Alcohol Use Disorder Identification Test (AUDIT)•

10 items (frequency, binge drinking, negative experience after drinking, etc.)

Perceived income inequality: Perception of income inequality in Korea•

1 question (1-7), higher score - higher perception of inequality

Depressive mood: The Center for Epidemiologic Studies of Depression (CES-D)•

11 items, higher score - higher level of depressive moodExperience of economic deprivation•

16 items in 5 areas (food, shelter, education, social deprivation, health)yes or no item. Higher score – higher level of deprivation

Methods

16 Indicators of Economic deprivation

Food

Lack of money to buy foodLack of balanced meal due to lack of money
Skipped meal or reduced food consumption
Had nothing to eat due to lack of money

Shelter

Could not pay rent for 2 months
Temporary shelter
Inadequate noise reduction, ventilation, lighting, heating
Inadequate level of noise, pollution, odor
Safe from natural disaster (flood, landslide, tidal wave, etc.)
Could not pay for heating
Could not pay for water, electricity

Socialdeprivation

Bankrupted person in the family
Could not pay for insurance or regular bills

HealthCould not receive medical care
Chronic illness

Education

Could not pay for children’s tuition

Conceptual Model

Perceived
incomeinequality

Economic
deprivation

Problem
drinking

Depressivemood

Control: sex, age, education, religion

Results : Demographic Characteristics
Sex

Education

N=13,553
31.1

43.1
56.9

27.7

27.0

college

graduate

12.0
2.2
elemantary

femalemiddlehighmale

Religion

Age

32.7

7.0

20s

12.1

30s

17.3

15.8

15.140s50s

60s

46.6

53.4

70+

yesnoResults

Perceived
incomeinequality

Economicdeprivation.067***

Depressivemood

Control: sex, age, education, religion

Problemdrinking

Discussion
Economic deprivation à depressive mood à problem drinking
Those who experience deprivation in many aspects in life are more likely to be
depressed, and are more vulnerable to drinking problems•

Economic deprivation à perceived income inequality à depressive
mood à problem drinking••

Those who experience deprivation have higher perception of inequality, and thisaffects one’s health through depressionInequality threatens psychosocial factors à bad health

Health inequity:
Unequal society leads to more prominent hierarchy in society, leading to less social
cohesion. This results in higher level of stress and anxiety which affects one’s health

Drinking behavior is a product of interaction between physical,
psychological, environmental factors

Implications
1. Most addiction professionals or social workers working with addiction tend to view
addiction as an individual’s problem. We need to expand our perspective toinclude a macro view of addiction.
2. It is easier for people with limited resources to turn to drinking as a coping
mechanism to many problems and life stress. Professionals need to understandthat these life problems and stress come from the social structure. Interventionsof alcohol problems must tailor to needs of specific groups.
3. Economic deprivation does not only mean financial deprivation. It includes
deprivation in many aspects.
•They are more vulnerable to problem drinking.

•Interventions of alcohol problems should consider both individual andstructural aspects.

Thank You
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