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AbstractA territory‐wide two‐stage stratified random sample of 2,282 community‐dwelling Hong Kong adults were surveyed between 2014 and 2015 to investigate the association between poverty and regular source of primary care utilization. Poverty was operationalized by income‐poverty and deprivation. About 94% of our sample reported having regular source of primary care (Western and/or Chinese medical practitioner) and about 69% among them were in private sector. Multivariable logistic regression showed that people who were income‐poor and deprived were less likely to have regular source of primary care (income‐poor: OR = 0.523,p= .027; deprived: OR = 0.488,p= .007) and visit private primary care doctors (income‐poor: OR = 0.445, deprived: OR = 0.222, bothp< .0001). Those who had chronic diseases were more likely to have regular source of primary care (multimorbid: OR = 10.709,p< .0001), but less likely to access care in the private sector (one chronic disease: OR = 0.690,p= .019; multimorbid: OR = 0.374,p< .0001) than those without. Further, being older and less skilled were significantly associated with less likelihood of visiting a private doctor. Path analysis showed that the number of chronic diseases had significant indirect effect on having regular source of primary care with being income‐poor and deprived as the mediators (β= −.0183,p= .0016). Therefore, despite a public health‐care system that aims to deny no one from adequate health care for lack of means, regular source of primary care in Hong Kong is found to be pro‐rich. Future policies should tackle the problem of health‐care inequalities to meet the needs of the underprivileged.

This study explores the social gradient of psychiatric morbidity. The Hong Kong Mental Morbidity Survey (HKMMS), consisting of 5719 Chinese adults aged 16 to 75 years, was used. The Chinese version of the Revised Clinical Interview Schedule (CIS-R) was employed for psychiatric assessment of common mental disorders (CMD). People with a less advantaged socioeconomic position (lower education, lower household income, unemployment, small living area and public rental housing) had a higher prevalence of depression and anxiety disorder. People with lower incomes had worse physical health (OR 2.01, 95% CI 1.05–3.82) and greater odds of having CMD in the presence of a family history of psychiatric illnesses (OR 1.67, 95% CI 1.18–2.36). Unemployment also had a greater impact for those in lower-income groups (OR 2.67; 95% CI 1.85–3.85), whereas no significant association was observed in high-income groups (OR 0.56; 95% CI 0.14–2.17). Mitigating strategies in terms of services and social support should target socially disadvantaged groups with a high risk of psychiatric morbidity. Such strategies include collaboration among government, civil society and business sectors in harnessing community resources.