MONTREAL — Adolescent well-being is influenced not only by the amount of socioeconomic deprivation young people face but also by the amount of deprivation relative to others in their sphere of influence, according to presentations at Public Health 2026, the annual meeting of the Canadian Public Health Association.

The findings point to the negative health effects of increasing social inequality in Canada and around the globe, researchers said.

Beyond Traditional Markers of Deprivation

The relationship between socioeconomic status and well-being among adolescents is well established, Victoria Michaelson, DMin, associate professor of health sciences at Brock University in St Catharines, Ontario, told Medscape News Canada. Food security and safe and secure housing are essential to well-being, but these are “a low bar to aim for when we’re talking about our children,” she said. “Things like having a sense of meaning in life are also profoundly connected to mental health.”

The concept of relative advantage/deprivation reflects how advantaged or disadvantaged a person feels, compared with others in their sphere. The concept comes from two lines of research, Frank J. Elgar, PhD, professor of psychology at McGill University in Montreal, told Medscape News Canada. One is on poverty and social status and looking at patterns in adolescent health and well-being. The other line of research is on economic or income inequality and its social effects.

“Relative deprivation is a way of bridging the two,” he said. “It’s not just about social rank or position. It’s also sensitive to the distribution of income, ie, how fair it is. So, at any level of income, you can increase your relative deprivation just by hanging around a lot of more affluent people.”

Relative Deprivation Decreases Well-Being and Flourishing

Michaelson, Elgar, and colleagues examined associations between relative advantage/deprivation and having a sense of meaning and purpose in life in a recent study of 17,634 Canadian adolescents. The authors found that those who were relatively advantaged, compared with their schoolmates, reported a higher sense of meaning and purpose in life. On the other hand, girls and gender-diverse youth in positions of relative deprivation reported lower levels of meaning and purpose. These effects were particularly pronounced in schools where social inequality was greatest. Michaelson presented the findings at the meeting. 

“We’re letting the gaps between the haves and the have-nots grow at an alarming pace without really seeing how they’re impacting our kids,” she told Medscape News Canada. “I do a lot of community-based research and talk to a lot of kids and take a rights-based perspective, and I think we’re just not giving our kids the world they deserve.”

Elgar then presented data that further explored the impact of relative deprivation around the globe. Data from a 2009-2023 Gallup survey of 423,219 youth from 160 countries and territories demonstrated a direct relationship between increasing relative deprivation (based on household income) and lower levels of optimism (beta coefficient, -16.00, P < .001), life satisfaction (beta coefficient, -12.50, P < .001), and perceived economic opportunities (beta coefficient, -14.96, P < .001).

Elgar and his team also explored data from the Global Flourishing Study, which included 25,239 youths living in 22 countries. This time, increasing relative deprivation, again based on household income, was associated with reductions in six measures of flourishing (assessed using the 11-point Secure Flourishing Scale): happiness and life satisfaction, physical and mental health, meaning and purpose, character and virtue, close social relationships, and financial and material stability. All associations were significant, ranging from -0.45 points for close social relationships to -1.12 points for financial and material stability. 

Over time, relative deprivation was associated with further declines in five of these six domains, from -0.28 for total flourishing to -0.46 for financial and material stability.

“Gross levels of inequality between rich and poor begin to fray social connections and networks, and societies just don't function the way they used to,” said Elgar. “We’ve done some work on measures of social capital and cohesion and group affiliations and trust, and all of these things are sensitive to income inequality, regardless of rank or position.”

"Inequality is really bad for your health, and that’s a political message as much as it’s anything else,” said Michaelson. “We can intervene up the river or mid-river, but unless we change those social structures, the kids are…out of luck if they’re at the bottom.”

This research was supported by the Public Health Agency of Canada and the Canadian Institutes of Health Research. Michaelson and Edgar reported having no relevant financial relationships.