Skip to main content

Advertisement

SpringerLink
Log in

Income or living standard and health in Germany: different ways of measurement of relative poverty with regard to self-rated health

  • Original Article
  • Published:
International Journal of Public Health

Abstract

Objectives

Current study introduces the living standard concept as an alternative approach of measuring poverty and compares its explanatory power to an income-based poverty measure with regard to subjective health status of the German population.

Methods

Analyses are based on the German Socio-Economic Panel (2001, 2003 and 2005) and refer to binary logistic regressions of poor subjective health status with regard to each poverty condition, their duration and their causal influence from a previous time point. To calculate the discriminate power of both poverty indicators, initially the indicators were considered separately in regression models and subsequently, both were included simultaneously.

Results

The analyses reveal a stronger poverty–health relationship for the living standard indicator. An inadequate living standard in 2005, longer spells of an inadequate living standard between 2001, 2003 and 2005 as well as an inadequate living standard at a previous time point is significantly strongly associated with subjective health than income poverty.

Conclusion

Our results challenge conventional measurements of the relationship between poverty and health that probably has been underestimated by income measures so far.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Andress HJ (1999) Living in poverty. Analyses of the behaviours of poor households with survey data. Westdeutscher, Opladen/Wiesbaden (in German)

    Google Scholar 

  • Andress HJ (2003) Does low income mean poverty? Some necessary extensions of poverty indicators based on economic resources. In: Krause P, Bäcker G, Hanesch W (eds) Combating poverty in Europe. The German welfare regime in practice. Ashgate, Aldershot, pp 117–130

    Google Scholar 

  • Andress HJ (2006) To the development of living standard and deprivation in Germany between 1996 and 2003. Vierteljahresh Wirtsch 75:131–151 (in German)

    Article  Google Scholar 

  • Andress HJ, Lipsmeier G (1999) Living standard depending not only on income. Results from a current study. Inf Soz Indik 21:5–9 (in German)

    Google Scholar 

  • Andress HJ, Lipsmeier G (2000) Research project: poverty and living standard. Circumstances in Germany. Survey in line with the first Poverty and Wealth Report. BMGS, Bonn (in German)

    Google Scholar 

  • Andress HJ, Lipsmeier G, Lohmann H (2001) Income, expenditures and standard of living as poverty indicators—different measures, similar results? Schmollers Jahrb 121:165–198

    Google Scholar 

  • Andress HJ, Krueger A, Sedlack BK (2004) Poverty and living standard. To the development of the necessary living standard in the population between 1996–2003. Circumstances in Germany. Survey in line with the second Poverty and Wealth Report. BMGS, Bonn (in German)

    Google Scholar 

  • Atkinson AB (1998) Poverty in Europe. Blackwell, Oxford

    Google Scholar 

  • Benzeval M, Judge K (2001) Income and health: the time dimension. Soc Sci Med 52:1371–1390

    Article  PubMed  CAS  Google Scholar 

  • Benzeval M, Tayler J, Judge K (2000) Evidence on the relationship between low income and poor health: is the government doing enough? Fisc Stud 21:375–399

    Article  Google Scholar 

  • Blane D, Davey Smith G, Bartley M (1993) Social selection: what does it contribute to social class differences in health? Soc Health Illn 15:1–15

    Article  Google Scholar 

  • Boarini R, d’Ercole MM (2006) Measures of material deprivation in OECD Countries. OECD Social, Employment and Migration Working Papers No. 37, Paris

  • Böhnke P, Delhey J (1999) Poverty in a multidimensional perspective. Great Britain and Germany in comparison. FS III 99-413, WZB-papers, Berlin

  • Böhnke P, Delhey J (2001) Living standard and income poverty. A pleading for an advanced poverty research. In: Barlösius E, Ludwig-Mayerhofer W (eds) The poverty of the society (in German). Leske + Budrich, Opladen

  • Bradshaw J, Finch N (2003) Overlaps in dimensions of poverty. J Soc Policy 32:513–525

    Article  Google Scholar 

  • Callan T, Nolan B, Whelan CT (1993) Resources, deprivation and the measurement of poverty. J Soc Policy 22:141–172

    Article  Google Scholar 

  • Citro CF, Michael RT (1995) Measuring poverty. A new approach. National Academy Press, Washington

    Google Scholar 

  • Deleeck H, van den Bosch K (1992) Poverty and adequacy of social security in Europe: a comparative analysis. J Eur Soc Policy 2:107–120

    Article  Google Scholar 

  • Delhausse B, Luttgens A, Perelman S (1993) Comparing measures of poverty and relative deprivation. An example of Belgium. J Popul Econ 6:83–102

    Article  PubMed  CAS  Google Scholar 

  • Desai M, Shah A (1988) An econometric approach to the measurement of poverty. Oxf Econ Pap 40:505–522

    Google Scholar 

  • Dowler EA, Dobson BM (1997) Nutrition and poverty in Europe: an overview. Proc Nutr Soc 56:51–62

    Article  PubMed  CAS  Google Scholar 

  • Drewnowski A, Specter SE (2004) Poverty and obesity: the role of energy density and energy costs. Am J Clin Nutr 79:6–16

    PubMed  CAS  Google Scholar 

  • Farmer MM, Ferraro KF (1997) Distress and perceived health: mechanisms of health decline. J Health Soc Behav 39:298–311

    Article  Google Scholar 

  • Fuchs J (1995) Does the income influences health? Empirical analyses with data of the German Socio-Economic Panel. Das Gesundheitswesen 57:746–752 (in German)

    PubMed  CAS  Google Scholar 

  • Grabka M (2002) The German Socio-Economic Panel (GSOEP): a forgotten data source for health reports? In: Robert Koch-Institut (ed) Health reports on working environment for Germany (in German). RKI, Berlin, pp 77–85

  • Greene WH (2008) Econometrics analysis, 6th edn. Pearson, New Jersey

    Google Scholar 

  • Groh-Samberg O, Goebel J (2007) The measurement of poverty across time. Indirect and direct poverty indicators in comparison. Wirtschaftsdienst 6:397–403 (in German)

    Article  Google Scholar 

  • Guio AC (2009) What can be learned from deprivation indicators in Europe. Eurostat Methodologies and Working Paper, Luxembourg

  • Gwatkin DR, Rutstein S, Johnson K, Suliman E, Wagstaff A, Amouzou A (2007) Socio-economic differences in health, nutrition, and population within developing countries. World Bank, Washington

    Google Scholar 

  • Hagenaars AJM, de Vos K, Zaidi M (1994) Poverty statistics in the late 1980s: research based on micro-data, theme 3, series C. Eurostat, Luxembourg

  • Hahn RA, Eaker E, Barker ND, Teusch SM, Sosniak W, Krieger N (1995) Poverty and death in the United States—1973 and 1991. Epidemiology 6:490–497

    Article  PubMed  CAS  Google Scholar 

  • Halleröd B (1994) A new approach to the direct consensual measurement of poverty. SPRC Discussion Paper No. 50. Social Policy Research Centre, Wales

  • Halleröd B (1995) The truly poor: direct and indirect consensual measurement of poverty in Sweden. J Eur Soc Policy 5:111–129

    Article  Google Scholar 

  • Halleröd B (1996) Deprivation and poverty: a comparative analysis of Sweden and Great Britain. Acta Sociol 39:141–168

    Article  Google Scholar 

  • Halleröd B (2006) Sour grapes: relative deprivation, adaptive preferences and the measurement of poverty. J Soc Policy 35:371–390

    Article  Google Scholar 

  • Halleröd B, Larsson D (2008) Poverty, welfare problems and social exclusion. Int J Soc Welf 17:15–25

    Google Scholar 

  • Halleröd B, Larsson D, Ritakallio VM (2006) Relative deprivation: a comparative analysis of Britain, Finland and Sweden. J Eur Soc Policy 16:328–345

    Article  Google Scholar 

  • Heinzel-Gutenbrenner M (2001) Income, income poverty and health. In: Mielck A, Bloomfield K (eds) Social epidemiology. An introduction to basic principles, results and application possibilities. Juventa, Weinheim, pp 39–49 (in German)

    Google Scholar 

  • Helmert U, Mielck A, Shea S (1997a) Poverty, health, and nutrition in Germany. Rev Environ Health 12:159–170

    Article  PubMed  CAS  Google Scholar 

  • Helmert U, Mielck A, Shea S (1997b) Poverty and health in West Germany. Soz Praventivmed 42:276–285

    Article  PubMed  CAS  Google Scholar 

  • Idler EL, Benyamini Y (1997) Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav 38:21–37

    Article  PubMed  CAS  Google Scholar 

  • Jensen J, Krishnan V, Spittal M, Sathiyandra S (2003) New Zealand Living Standard: their measurement and variation, with an application to policy. Soc Policy J NZ 20:72–97

    Google Scholar 

  • Jensen J, Sathiyandra S, Matangi-Want M (2007) The 2004 New Zealand Living Standard Survey: what does it signal about the importance of multiple disadvantage? Soc Policy J NZ 30:110–143

    Google Scholar 

  • Jylhä M (2009) What is self-rated health and why does it predict mortality? Towards a unified conceptual model. Soc Sci Med 69:307–316

    Article  PubMed  Google Scholar 

  • Kangas O, Ritakallio VM (1998) Different methods–different results? Approaches to multidimensional poverty. In: Andress HJ (ed) Empirical poverty research in a comparative perspective. Ashgate, Aldershot, pp 167–203

    Google Scholar 

  • Klocke A (2000) Poverty measurement methods. Approaches of Income, Undersupply, Deprivation and social Benefits in comparison. Z Soziol 29:313–329 (in German)

    Google Scholar 

  • Lampert T, Kroll LE (2006) Income differences in health and life expectancy—cross sectional and longitudinal findings of the German Socio-Economic Panel (GSOEP). Das Gesundheitswesen 68:219–230 (in German)

    Article  PubMed  CAS  Google Scholar 

  • Layte R, Maitre B, Nolan B, Whelan CT (2001) Persistent and consistent poverty in the 1994 and 1995 waves of the European Community Household Panel Survey. Rev Income Wealth 47:427–449

    Article  Google Scholar 

  • Lipsmeier G (1999) The identification of a necessary living standard—appraisal differences and decision problems. Z Soziol 28:281–300 (in German)

    Google Scholar 

  • Lipsmeier G (2001) Potential and problems of the deprivation approach in poverty research. Arch Wiss Prax soz Arb 32:3–29 (in German)

    Google Scholar 

  • Lorant V, Croux CC, Weich S, Deliège D, Mackenbach J, Ansseau M (2007) Depression and socio-economic risk factors: 7-year longitudinal population study. Br J Psychiatry 190:293–298

    Article  PubMed  Google Scholar 

  • Lynch JW, Kaplan GA, Shema SJ (1997) Cumulative impact of sustained economic hardship on physical, cognitive, psychological, and social functioning. New Engl J Med 337:1889–1895

    Article  PubMed  CAS  Google Scholar 

  • Mack J, Lansley S (1985) Poor Britain. Allan and Unwin, London

    Google Scholar 

  • Mayer SE (1993) Living conditions among the poor in four rich countries. J Popul Econ 6:261–286

    Article  Google Scholar 

  • Mayer SE, Jencks C (1989) Poverty and the distribution of material hardship. J Hum Resour 24:88–113

    Article  Google Scholar 

  • McDonough P, Berglund P (2003) Histories of poverty and self-rated health trajectories. J Health Soc Behav 44:198–214

    Article  PubMed  Google Scholar 

  • McDonough P, Sacker A, Wiggins RD (2005) Time on my side? Life course trajectories of poverty and health. Soc Sci Med 61:1795–1808

    Article  PubMed  Google Scholar 

  • McKay S (2004) Poverty or preferences: what do ‘consensual deprivation indicators’ really measure? Fisc Stud 25:201–223

    Article  Google Scholar 

  • Muffels RJA (1993) Deprivation standards and style of living indices. In: Bergham J, Cantillon B (eds) The European face of social security. Avebury, Aldershot, pp 43–59

    Google Scholar 

  • Muffels RJA, Bergham J, Dirven HJ (1992) A multi-method approach to monitor the evolution of poverty. J Eur Soc Policy 2:193–213

    Article  Google Scholar 

  • Murray S (2006) Poverty and health. Can Med Assoc J 174:923

    Article  Google Scholar 

  • Nielsen MJ, Juon HS, Ensminger M (2004) Preventing long-term welfare receipt: the theoretical relationship between health and poverty over the early life course. Soc Sci Med 59:2285–2301

    Article  PubMed  Google Scholar 

  • Nolan B, Whelan CT (1996a) Resources, deprivation and poverty. Clarendon, Oxford

    Google Scholar 

  • Nolan B, Whelan CT (1996b) Measuring poverty using income and deprivation indicators: alternative approaches. J Eur Soc Policy 6:225–240

    Article  Google Scholar 

  • Nolan B, Whelan CT (2007) On the multidimensionality of poverty and social exclusion. In: Jenkins SP, Micklewright J (eds) Inequality and poverty re-examined. Oxford University Press, Oxford, pp 146–165

    Google Scholar 

  • Nolte E, McKee M (2004) Changing health inequalities in East and West Germany since unification. Soc Sci Med 58:119–136

    Article  PubMed  Google Scholar 

  • Perry B (2002) The mismatch between income measures and direct outcome measures of poverty. Soc Policy J NZ 19:101–127

    Google Scholar 

  • Peters DH, Garg A, Bloom G, Walker DG, Brieger WR, Rahman MH (2008) Poverty and access to health care in developing countries. Ann NY Acad Sci 1136:161–171

    Article  PubMed  Google Scholar 

  • Piachaud D (1987) Problems in the definition and measurement of poverty. J Soc Policy 16:147–164

    Article  Google Scholar 

  • Regidor E, Calle ME, Navarro P, Dominguez V (2003) Trend in the association between average income, poverty and income inequality and life expectancy in Spain. Soc Sci Med 56:961–971

    Article  PubMed  Google Scholar 

  • Ringen S (1988) Direct and indirect measures of poverty. J Soc Policy 16:147–167

    Google Scholar 

  • Robine RM, Jagger C, Euro-REVES Group (2003) Creating a coherent set of indicators to monitor health across Europe—the Euro-REVES 2 project. Eur J Public Health 83:397–423

    Google Scholar 

  • Santana P (2002) Poverty, social exclusion and health in Portugal. Soc Sci Med 55:33–45

    Article  PubMed  Google Scholar 

  • Shaw M, Dorling D, Davey Smith G (2006) Poverty, social exclusion, and minorities. In: Marmot M, Wilkinson RG (eds) Social determinants of health, 2nd edn. Oxford University Press, Oxford, pp 196–223

    Google Scholar 

  • Short KS (2005) Material and financial hardship and income-based poverty measures in the USA. J Soc Pol 34:21–38

    Article  Google Scholar 

  • SOEP Group (2001) The German Socio-Economic Panel (GSOEP). After more than 15 years—overview. Vierteljahresh Wirtsch 70:7–14

    Article  Google Scholar 

  • Stronks K, van de Mheen HD, Mackenbach JP (1998) A higher prevalence of health problems in low income groups: does it reflect relative deprivation. J Epidemiol Commun Health 52:548–557

    Article  CAS  Google Scholar 

  • Sturm R, Wells KB (2001) Does obesity contribute as much to morbidity as poverty or smoking? Public Health 115:229–235

    Article  PubMed  CAS  Google Scholar 

  • Thiede M, Traub S (1997) Mutual influences of health and poverty. Evidence from German panel data. Soc Sci Med 45:867–877

    Article  PubMed  CAS  Google Scholar 

  • Townsend P (1979) Poverty in the United Kingdom. A survey of household resources and standard of living. Penguin Books, Harmondsworth

    Google Scholar 

  • Townsend P (1987) Deprivation. J Soc Policy 16:125–146

    Article  Google Scholar 

  • Vetter S, Endrass J, Schweizer I, Teng HM, Rossler W, Gallo WT (2006) The effects of economic deprivation on psychological well-being among the working population of Switzerland. BMC Public Health 6:223

    Article  PubMed  Google Scholar 

  • Wagner G, Frick JR, Schupp J (2007) The German Socio-Economic Panel Study (SOEP)—scope, evolution, and enhancements. Schmollers Jahrb 127:139–169

    Google Scholar 

  • Wagstaff A (2002) Poverty and health sector inequalities. Bull World Health Organ 80:97–105

    PubMed  Google Scholar 

  • Walker R (1987) Consensual approaches to the definition of poverty: towards an alternative methodology. J Soc Policy 16:213–226

    Article  Google Scholar 

  • Whelan BJ (1993) Non-monetary indicators of poverty. In: Bergham J, Cantillon B (eds) The European face of social security. Ashgate, Avebury, Aldershot, pp 24–42

    Google Scholar 

  • Whelan CT, Maitre B (2006) Comparing poverty and deprivation dynamics: Issues of reliability and validity. J Econ Inequal 4:303–323

    Article  Google Scholar 

  • Whelan CT, Maitre B (2009) The ‘Europeanisation’ of reference groups. A reconsideration using EU-SILC. Eur Soc 11:283–309

    Article  Google Scholar 

  • Whelan CT, Layte R, Maitre B, Nolan B (2001) Income, deprivation, and economic strain. An analysis of the European Community Household Panel. Eur Sociol Rev 17:357–372

    Article  Google Scholar 

  • Whelan CT, Layte R, Maitre B (2002a) Multiple deprivation and persistent poverty in the European Union. J Eur Soc Policy 12:91–105

    Article  Google Scholar 

  • Whelan CT, Layte R, Maitre B (2002b) Persistent deprivation in the European Union. Schmollers Jahrb 122:31–54

    Google Scholar 

  • Whelan CT, Layte R, Maitre B (2003) Persistent income poverty and deprivation in the european union: an analysis of the first three waves of the European Community Household Panel. J Soc Policy 32:1–18

    Article  Google Scholar 

  • Whelan CT, Layte R, Maitre B (2004) Understanding the mismatch between income poverty and deprivation: a dynamic comparative analysis. Eur Soc Rev 20:287–302

    Article  Google Scholar 

  • Wooldridge JM (2003) Introductory econometrics. A modern approach, 2nd edn. Thomson South Western, Mason

    Google Scholar 

  • World Health Organization (1996) Health interview surveys: toward an international harmonization of methods and instruments. WHO Office for Europe, Copenhagen

  • Zaidi SA (1988) Poverty and disease: need for structural change. Soc Sci Med 27:119–127

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest statement

None.

Author information

Authors and Affiliations

  1. Cologne, Germany

    Timo-Kolja Pfoertner & Hans-Juergen Andress

  2. Department of Applied Social Sciences, Hochschule Munic, Munich, Germany

    Christian Janssen

Authors
  1. Timo-Kolja Pfoertner
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hans-Juergen Andress
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Christian Janssen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Timo-Kolja Pfoertner.

Additional information

This paper belongs to the special issue “Monitoring Social Determinants of Health”.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pfoertner, TK., Andress, HJ. & Janssen, C. Income or living standard and health in Germany: different ways of measurement of relative poverty with regard to self-rated health. Int J Public Health 56, 373–384 (2011). https://doi.org/10.1007/s00038-010-0154-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00038-010-0154-3

Keywords

Search

Navigation