The Associations of Income, Education and Income Inequality and Subjective Well-Being among Elderly in Hong Kong—A Multilevel Analysis

Abstract

Background: Higher income and education and lower income inequality in a neighbourhood have been shown to be related to better mental health outcome in developed countries. However, it is not clear whether these factors would affect the subjective well-being of the elderly, especially in a setting with recent rapid economic development. Methods: This study was conducted in 80 community centres with a total of 7552 community-dwelling elderly (mean age 75.9 years (SD = 7.79), 79% female) in Hong Kong. Income at individual level was measured as perceived disposable income. Education level was also collected. At district level, income was measured by district median household income and education was measured as the proportion of the population with no formal schooling. Income inequality was quantified using Gini coefficients. Low subjective well-being was defined as any one or a combination of the following: not satisfied with life, no meaning of life and being unhappy (Likert scale ≤ 2). Multilevel logistic regression was used to assess the association of income, education and income inequality and low subjective well-being. Results: We found that 15.3% (95% confidence interval (CI): 14.5 to 16.1) of the elderly have low subjective well-being. Compared with elderly who reported a very adequate disposable income, those who reported a very inadequate disposable income are at increased risk of low subjective well-being (OR=5.08, 95%CI: 2.44 to 10.59). Compared with elderly with tertiary education, those with no formal schooling were at higher risk (OR=1.60, 95%CI 1.22 to 2.09). Income inequality was not related to subjective well-being. Conclusions: Elderly with inadequate disposable income and lower education level are more likely to suffer from low subjective well-being. At the neighbourhood level, income inequality was not related to subjective well-being. However, the relationships between neighbourhood income and education level and individuals’ subjective well-being are not clear.