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Comparison of individual-level versus area-level socioeconomic measures in assessing health outcomes of children in Olmsted County, Minnesota
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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“different measures of SES are potentially not comparable”
From Mediators of socioeconomic inequalities in preterm birth: a systematic review (2022) · cites this paper as [67]
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“There is evidence that disagreement can occur between these measures [67]”
From Mediators of socioeconomic inequalities in preterm birth: a systematic review (2022) · cites this paper as [67]
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“However, a few studies [35,48,49] suggested that from fully adjusted models (including both individual- and family-level characteristics), the effect of neighborhood socioeconomic status was not as important as previously demonstrated [35,48].”
From A Comprehensive Review on Social Inequalities and Pregnancy Outcome—Identification of Relevant Pathways and Mechanisms (2022) · cites this paper as [48]
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Cited by
Mediators of socioeconomic inequalities in preterm birth: a systematic review
McHale, P., Maudsley, G., Pennington, A., Schlüter, D. K., Barr, B., Paranjothy, S., & Taylor-Robinson, D. (2022) · BMC Public Health · doi:10.1186/s12889-022-13438-9 · Cited by 89
Juhn, Y. J., Ryu, E., Wi, C.-I., King, K. S., Malik, M., Romero-Brufau, S., Weng, C., Sohn, S., Sharp, R. R., & Halamka, J. D. (2022) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocac052 · Cited by 83
Self-citationSimoncic, V., Deguen, S., Enaux, C., Vandentorren, S., & Kihal-Talantikite, W. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192416592 · Cited by 83
Ziegeldorf, A., Schoene, D., Fatum, A., Brauer, K., & Wulff, H. (2024) · BMC Public Health · doi:10.1186/s12889-024-19174-6 · Cited by 41
Amjad, S., Chandra, S., Osornio-Vargas, A., Voaklander, D., & Ospina, M. B. (2019) · Journal of Obstetrics and Gynaecology Canada · doi:10.1016/j.jogc.2019.02.126 · Cited by 34
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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