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The Chinese University of Hong Kong (CUHK) Institute of Health Equity, in collaboration with the University College London Institute of Health Equity (UCL IHE), has published a report which reveals the serious health inequalities faced by Hong Kong people at different stages of their lives. The mental health situation among adolescents is alarming, with the study showing that 45.6 percent of young people have reported symptoms of post-traumatic stress disorder. Both the government and business sector should address ill health due to overwork, with 17.6 percent of workers in low-paying sectors working 60 hours or more a week.

A life course approach to examining social inequalities in Hong Kong

Based on available government statistics and reports, academic research and studies in Hong Kong and benchmarked against international standards, the report outlines the systematic inequalities that affect a person from early childhood through their adolescence and working life to old age. Taking a life course approach, the report systematically reviews how different social determinants of health – social conditions in which people are born, grow, work, live and age, and the wider set of forces and systems shaping these conditions of daily life – operate at every level to affect the health of a person at particular critical periods and cumulatively over time.

Alarming mental health situation among adolescents and young adults

The report revealed the prevalent and deteriorating mental health problems of Hong Kong adolescents and young adults in the context of social unrest and the pandemic. While a study on people aged over 18 showed that the prevalence of suspected post-traumatic stress disorder (PTSD) was 12.8 percent in 2019, a 2020 study of nearly 11,500 people (49 percent aged under 25) found that close to half of those aged 24 or younger reported symptoms of PTSD.

Mental health among schoolchildren in Hong Kong was also poor. A 2020 study found that primary and secondary school students in Hong Kong scored 6.97 points on life satisfaction, while the average score across 45 countries was 7.8 in 2017/18. Only 18 percent of Hong Kong students were very satisfied with their current life. Inequalities of poor mental health are evident – the higher the family’s socioeconomic status, the higher the student’s life satisfaction and self-rated health. A recent study by the CUHK Institute of Health Equity on secondary school students across the territory revealed that psychosocial well-being of the students worsened amid the pandemic. Those who were socially disadvantaged showed greater deterioration, possibly due to differences in family support, learning difficulties and loneliness.

In view of this alarming situation, the report recommends that the government should conduct regular surveys, using the results to understand the current situation and inform investment and actions, aiming to improve the social determinants of mental health and reduce socioeconomic inequalities in the prevalence of mental health problems.

Business sector has a critical role in improving health equity in Hong Kong

The report uses government data and research to show that workers with lower incomes or educational attainment often experience worse working conditions. In particular, workers in low-paying sectors, such as retail, food and beverage, estate management, security and cleaning, suffered from low wages and long hours, worsening their physical and mental health and increasing health inequalities. Low-skilled workers are more vulnerable to unemployment, especially during times of economic turmoil.

To this end, the report recommends that businesses should consider providing an environment that is more conducive to physical, mental and social health, and fostering a more family-friendly culture. The working environment should also be free from occupational injuries and avoid excessively long hours. The government should consider putting in place stronger regulations regarding working time.  

The CUHK Institute of Health Equity has joined hands with the Hong Kong Trade Development Council to promote this message in the session Adding Health to ESG: How Businesses Can Impact Health Equity in the Asia Summit on Global Health on 11 November 2022. In a dialogue session with Professor Sir Michael Marmot, CUHK Vice-Chancellor and President Professor Rocky S. Tuan will outline how organisations can improve the health of employees, using CUHK as an example. Another dialogue session will draw insights of the report The Business of Health Equity; The Marmot Review for Industry published by UCL IHE earlier this year to dissect the role of businesses and organisational culture and policies in shaping our health.

The report makes six recommendations to reduce health inequalities in Hong Kong. Details can be found in the full report at https://www.ihe.cuhk.edu.hk/reports/