 on social comparisons of income, is significantly associated with premature mortality in Sweden, over and above the effect of absolute income. Also, it was found to be more important among men, but weak among the poorest.
Income enables people to purchase the goods and services they need to maintain health – e.g. food, clothing, shelter. Consequently, lack of income (or income poverty) is associated with worse health status . Beyond this direct relationship between income and command over resources, researchers have posed the question of whether an individual’s income relative to other people’s income might also influence his/her level of health. Broadly speaking, the relative income hypothesis has been empirically examined in two streams of research. One stream has sought to test the relationship between aggregate income distribution and health [2,3]. Researchers belonging to this school have been interested in answering the question of whether an individual with a given level of income would experience different health outcomes depending on the distribution of incomes of other people living in the same society. A meta-analysis of 28 multi-level studies suggests that there is a “contextual” effect of income inequality on poor health that is independent of an individual’s level of income. On average, a 0.05 unit increase in the Gini coefficient (a standard measure of income inequality) is associated with roughly an 8\% increase in the risk of mortality . However, how these studies should be interpreted continues to be debated, owing to the possibility of residual confounding by the unobserved characteristics of societies that have high or low income dispersion.
A second stream of research on the relative income hypothesis has sought to focus on the individual-level relationships between the concept of “relative deprivation” and health status. The theory of relative deprivation dates back to WG Runciman , who argued that having less income relative to some comparison (or reference) group can lead to feelings of frustration and injustice. Researchers taking this approach have sought to demonstrate that, over and above the increased command over resources, income matters to individuals because it is the basis of social comparisons between a person and his/her reference group [5-8]. Social comparisons have previously been analyzed as a possible mechanism underlying the income-health relation [7-9], and have been linked with happiness  as well as outcomes such as deviant behaviour among adolescents .
Drawing on Runciman’s theory, Yitzhaki  proposed an index for estimating relative deprivation, calculating the accumulated shortfall between one’s own income and the incomes of all others in one’s reference group. Recent studies have used the Yitzhaki index when analyzing the importance of individual relative deprivation for health [5,6,13-17]. Studies in the US have generally reported evidence in support of the hypothesis that relative deprivation is associated with increased risks of mortality , mental health services utilization , and poor self-rated health . In Japan, Kondo and colleagues studied the association between relative deprivation, measured by the Yitzhaki index, and self-rated health . The overall result indicated that relative deprivation was associated with poor self-rated health, regardless of the reference group used and independent of absolute income. By contrast, studies based in the UK have failed to demonstrate an association between relative deprivation and health [16,17].
The goal of the present study was to conduct an empirical test of relative deprivation and mortality in Sweden – a society that is characterized by a strong egalitarian ethos, as well as a relatively flat degree of income dispersion (in contrast to countries such as the US or UK) . According to Bernburg , the individual experience of relative deprivation may be more prominent in a context that promotes values such as egalitarianism, upward social mobility, equal opportunity and individual achievement. In the present study, we therefore 