Valuing the impact of Self-rated Health and Social Support on life satisfaction among Hong Kong Chinese population

DOI: https://doi.org/10.21203/rs.3.rs-155505/v1

Abstract

Background

Research has highlighted that satisfaction in health and social support are key areas of life affecting individual’s wellbeing. Many social and public health initiatives use these two intervention mechanisms to improve individual’s wellbeing. For the purpose of cost-benefit assessment, there has been growing interest in expressing these intervention effects in economic terms. However, only a handful of studies have ever estimated these effects in economic terms, and none of which examined in a Chinese context. The aim of this study is to extend this line of valuation work to estimate the implicit willingness-to-pays on the effects of improving individuals’ self-rated health status (SRH) and social support (SS) on their life satisfaction in the Chinese population.

Methods

Using individual’s life satisfaction data from a two-wave representative panel survey in Hong Kong (n = 1,109), this study first conducted a cross-lagged analysis with structural equation modelling technique to examine the causal effects of SRH and SS on life satisfaction, while simultaneously adjusting their reverse causal influences. The use of this cross-lagged approach was the effort to minimising the endogeneity problem. Then, substituting the respective estimates to the formulae of compensating surplus, the marginal rate of substitution of SRH and SS with respect to individual’s equivalised monthly household were estimated and were then expressed as the willingness-to-pays on the effect of improving individuals’ SRH and SS on their life satisfaction.

Results

The cross-lagged analysis ascertained the casual effects of SRH (β = 0.078, 95%CI: 0.020, 0.151) and SS on individuals’ satisfaction with life. The sample’s marginal rate of substitution of SRH and SS were found to be 1.28 (95%CI: 0.43, 2.15) and 1.36 (95%CI: 0.23, 2.49) respectively. Translating into the concept of compensating surplus, the implicit monetary values of improving the sample’s SRH from “poor health” to “excellent health” and their SS from “little support” to “a lot of support” are equivalent to an increase in their equivalised monthly household income by HK$56,000 and HK$39,400 respectively.

Conclusions

This study has implications for the cost-benefit assessment in wellbeing initiatives for the Chinese population.

Full Text

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Tables

Table 1 Sample’s socioeconomic characteristics and descriptive statistics on the main variables of interest (N = 1,109)

Sample’s characteristics

N (%)

Socioeconomic Status

 

Age

54.4 ± 16.9

Sex

 

 

 Men

532

(47.9%)

 Women

577

(52.1%)

Employment status

 

 

 Employed

458

(41.3%)

 Unemployed

417

(37.6%)

 Economically inactive

234

(21.1%)

Marital Status

 

 

 Never married

219

(19.8%)

 Married / cohabited

677

(61.0%)

 Separated / divorced / Widowed

213

(19.2%)

Education attainment

 

 

 Not educated

320

(28.9%)

 Primary

244

(22.0%)

 Secondary

348

(31.3%)

 Territory or above

197

(17.8%)

Household Size

 

 

 One-person household

157

(14.1%)

 Two-person household

293

(26.4%)

 Three-person household

296

(26.7%)

 Four-person household or more)

363

(32.7%)

Main variables of interest

Wave 1

 

Wave 2

 SRH

2.21 ± 0.91

 

2.20 ± 0.89

 SS

7.41 ± 2.69

 

7.59 ± 2.56

 HI

14.2 ± 13.0

 

16.5 ± 16.4

 LS

21.95 ± 7.23

 

21.95 ± 7.24

SRH: self-rated health status; SS: social support; HI: equivalised monthly household income; LS: life satisfaction

Range of SRH: 1-5; range of SS: 3-12; range of LS: 5-35