Relationship between relative deprivation and health of Hainan Island residents: mediating effect of negative health behaviors.

Despite extensive evidence of the direct impact of relative deprivation on health, the mediating role of tobacco, alcohol and betel nuts in this impact has been largely ignored. This study aimed to verify whether these negative health behaviors are mediating factors for relative deprivation and health according to the mediating effect concept. Data from the Hainan Island Residents Health Interview Survey in 2017 were used. Variables including age, marital status, educational level, chronic diseases and area of residence were controlled for in multivariate analysis with separate sex analyses. Mediating effects of smoking, alcohol drinking and betel nut chewing, and whether the effects were complete or partial, were analyzed by logistic regression analysis. Smoking, alcohol drinking and betel nut chewing had a significant mediating effect in men, but not in women; however, alcohol drinking and betel nut chewing had similar, significant complete mediation in both sexes. Dissatisfaction following relative deprivation due to uneven income distribution may be relieved through these negative health behaviors. Therefore, better medical resources should be provided to improve residents' health and the impact of income inequality on health, particularly the growing gap between the rich and poor, should be addressed.