Ill-health and Poverty: Physical Health Outcomes of Low-income Populations in Hong Kong

Abstract

Introduction: The inextricable relationship between poverty and ill-health is well-documented worldwide and can be intergenerational. Although Hong Kong has a high GDP per capita, income inequality is severe, which may lead to health disparities across socioeconomic groups. A better understanding of poverty and physical health can better inform health policy on reducing health inequities. This systematic review aimed to critically appraise the existing literature on physical health outcomes of low-income families in Hong Kong. Methods: Articles that were original pieces of research, conducted in Hong Kong, examined low-income populations, and assessed physical health-related outcomes were included. Electronic databases PubMed, PsycINFO and Scopus were searched according to PRISMA guidelines, using keywords related to ‘low-income’(e.g. ‘poverty’, socioeconomic’), ‘Hong Kong’, ‘physical health’ (e.g. ‘health-status’, ‘cancer’, ‘cardiovascular’, ‘diabetes’) and risk factors (e.g. ‘tobacco’, ‘diet’). Results: 560 articles were identified, 64 screened and 11 eligible for inclusion. 3 were cohort studies and 8 were crosssectional. Low-income individuals have higher risk of multimorbidity, with a higher prevalence of obesity, hypertension and diabetes. Lower SES is associated with higher risk of childhood obesity and hypertension, which can severely affect both short term and long term health. The lack of accessibility to healthy food options is also detrimental to health of low-income families, increasing their risk of non-communicable diseases. Oral health for low-income families worsens without universal access to publicly-funded dental services. Low-income families are more prone to infectious diseases such as tuberculosis and experience increased mortality risks associated with air pollution. Conclusions: There are gradients of physical health across different income groups in Hong Kong. Physicians should be aware of the complex health-related conditions low-income populations experience in order to provide better support. A good primary healthcare system has been shown to improve health outcomes and reduce health inequities, and should be made more accessible to low-income populations in Hong Kong.