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Comparison of individual-level versus area-level socioeconomic measures in assessing health outcomes of children in Olmsted County, Minnesota

Pardo-Crespo, Maria R, Narla, Nirmala Priya, Williams, Arthur R, Beebe, Timothy J, Sloan, Jeff, Yawn, Barbara P, Wheeler, Philip H, Juhn, Young J·2013·Journal of Epidemiology and Community Health

Abstract

Background: Socioeconomic status (SES) is an important determinant of health, but SES measures are frequently unavailable in commonly used datasets. Area-level SES measures are used as proxy measures of individual SES when the individual measures are lacking. Little is known about the agreement between individual-level versus area-level SES measures in mixed urban–rural settings. Methods: We identified SES agreement by comparing information from telephone self-reported SES levels and SES calculated from area-level SES measures. We assessed the impact of this agreement on reported associations between SES and rates of childhood obesity, low birth weight <2500 g and smoking within the household in a mixed urban–rural setting. Results: 750 households were surveyed with a response rate of 62%: 51% male, 89% Caucasian; mean child age 9.5 years. Individual-level self-reported income was more strongly associated with all three childhood health outcomes compared to area-level SES. We found significant disagreement rates of 22–31%. The weighted Cohen's κ indices ranged from 0.15 to 0.22, suggesting poor agreement between individual-level and area-level measures. Conclusion: In a mixed urban–rural setting comprised of both rural and urbanised areas, area-level SES proxy measures significantly disagree with individual SES measures, and have different patterns of association with health outcomes from individual-level SES measures. Area-level SES may be an unsuitable proxy for SES when individual rather than community characteristics are of primary concern.

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Metadata

Authors
Pardo-Crespo, M. R., Narla, N. P., Williams, A. R., Beebe, T. J., Sloan, J., Yawn, B. P., Wheeler, P. H., & Juhn, Y. J.
Affiliations
  • Division of Community Paediatric and Adolescent Medicine, Department of Paediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
  • Mayo Medical School, Mayo Clinic, Rochester, Minnesota, USA
  • Department of Health Policy and Management, College of Public Health, University of South Florida, Tampa, Florida, USA
  • Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
  • Department of Research, Olmsted Medical Center, Rochester, Minnesota, USA
  • Rochester Olmsted Planning Department, Olmsted County, Rochester, Minnesota, USA
Venue
Journal of Epidemiology and Community Health
Publisher
BMJ
Published
2013-01-15
Volume
67
Issue
4
Pages
305-310
ISSN
  • 0143-005X
  • 1470-2738
Cited by
111
References
2
Language
en

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