{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T13:05:18Z","timestamp":1785416718459,"version":"3.56.0"},"reference-count":41,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"unspecified","delay-in-days":29,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"General Research Fund of the Research Grants Council of Hong Kong","award":["14607819"],"award-info":[{"award-number":["14607819"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,7,20]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To explore the cross-sectional and longitudinal associations of poverty, assessed by deprivation index (DI) and income, with anxiety and stress among adults<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Longitudinal cohort observational study<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A cohort of adults established in 2014\u20132015 (T1) in Hong Kong.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>493 participants (177 men, median age 56 years) were followed up in the third wave of household survey in 2021\u20132022 (T3).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Self-reported equivalised household income and DI, measured as material and social deprivation, were recorded. Anxiety and stress were assessed using the Depression, Anxiety and Stress Scale-21 items (Chinese) version.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Being deprived in T3 is significantly associated with higher anxiety and stress score in T3 as compared with being non-deprived cross-sectionally. Income status did not show significant association with anxiety and stress score cross-sectionally in T3. Increased deprivation status since baseline is significantly associated with higher anxiety and stress score in T3 than persistent non-deprivation. Being able to afford one less basic necessity throughout T1\u2013T3 is significantly associated with 0.31-unit higher anxiety score (95%\u2009CI 0.18 to 0.45)\u2009and 0.36-unit higher stress score (95%\u2009CI 0.18 to 0.55) across time.<\/jats:p>\n                    <jats:p>Subgroup analyses further showed that income-poor younger adults aged less than 60 years tended to have higher anxiety and stress scores than their non-income-poor counterparts in the same age group in T3 cross-sectionally. Younger adults with occasional non-income-poverty throughout T1\u2013T3 also had higher anxiety and stress scores in T3 than persistently non-income-poor younger adults. This relationship of income-poverty with anxiety and stress was not significant among older adults aged 60 years or above.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Individual deprivation and increased deprivation over time were associated with higher anxiety and stress scores in T3 cross-sectionally and longitudinally respectively. Young adults\u2019 anxiety and stress scores tended to be more affected by income-poverty than their older counterparts. Nevertheless, sample attrition may occur as a proportion of participants dropped out throughout the 7 years of follow-up.<\/jats:p>\n                    <jats:p>Age-specific poverty measurement tools may be developed to assess the age-specific standard of living. Policymakers may consider deprivation, in addition to income, as well as change in poverty status, in healthcare and social welfare policymaking to better address the mental health of the population and health inequality in the region.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-100850","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T12:45:14Z","timestamp":1785415514000},"page":"e100850","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Associations of deprivation and income-poverty with anxiety and stress among Hong Kong adults: a longitudinal household survey"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0569-6177","authenticated-orcid":false,"given":"Tobey Tsz-yan","family":"Lee","sequence":"first","affiliation":[{"name":"JC School of Public Health and Primary Care, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dicken Cheong Chun","family":"Chan","sequence":"additional","affiliation":[{"name":"JC School of Public Health and Primary Care, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Social Work, The Chinese University of Hong Kong, Hong Kong, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maggie Ka-wai","family":"Lau","sequence":"additional","affiliation":[{"name":"School of Graduate Studies, Lingnan University, Hong Kong, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel Yeung Shan","family":"Wong","sequence":"additional","affiliation":[{"name":"JC School of Public Health and Primary Care, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hung","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Social Work, The Chinese University of Hong Kong, Hong Kong, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dave","family":"Gordon","sequence":"additional","affiliation":[{"name":"Bristol Poverty Institute, University of Bristol, Bristol, England, UK"},{"name":"Townsend Centre for International Poverty Research, University of Bristol, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4407-8208","authenticated-orcid":false,"given":"Roger Yat-Nork","family":"Chung","sequence":"additional","affiliation":[{"name":"JC School of Public Health and Primary Care, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong, Hong Kong"},{"name":"CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong, Hong Kong"},{"name":"CUHK Centre for Bioethics, The Chinese University of Hong Kong, Hong Kong, Hong Kong"},{"name":"CUHK Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"key":"2026073005450574000_16.7.e100850.1","unstructured":"World Health Organization . 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