CoChat
Sign Up
Cited by 41Health disparities and outcomesPublic Health and Social InequalitiesHealth Education and Validation

The DOI matches its Crossref record.

Development and validation of the Socioeconomic Status Composite Scale (SES-C)

Open access
Sacre, Hala, Haddad, Chadia, Hajj, Aline, Zeenny, Rony M., Akel, Marwan, Salameh, Pascale·2023·BMC Public Health
DOI 10.1186/s12889-023-16531-9PMC PMC10464400
Open this paper in CoChat — free accountOpen PDF

Abstract

Background: Socioeconomic status (SES) is a critical multifactorial determinant of health and plays a significant role in shaping an individual’s health outcomes. While a composite scale has been proposed to measure SES in children, to our knowledge, limited composite scales were developed for adults in different contexts, highlighting the need for a comprehensive and valid SES measure to elucidate the relationship between SES and health in this population. Objective: This study aimed to develop and validate a composite scale that measures the socioeconomic status in Lebanon and assess its correlates in a socioeconomic crisis context. Methods: An online study was carried out between October and November 2022 across all Lebanese regions. Snowball sampling was used to enroll 448 adults living in Lebanon through a questionnaire created on Google Forms and shared by WhatsApp to a first sample from all geographic areas. Results: The developed composite scale (SES-C) was found to be reliable and valid. It was based on several aspects of socioeconomic status, i.e., participant education level, family head education level, perceived social class, not being in debt, not receiving financial help, crowding index, participant work status, family head work status, monthly household income, and financial well-being. Furthermore, high SES was significantly associated with married status, older age, alcohol consumption, the absence of chronic disease, easy access to healthcare, private insurance coverage, and the number of rooms in the house in the bivariate analysis. In the multivariable analysis, high SES was significantly associated with age (ORa-1.13; p = 0.011) and easy access to healthcare (ORa = 7.81; p = 0.001) and inversely associated with chronic disease (ORa = 0.17; p = 0.002). Similar results with lower magnitude were found for moderate SES. Conclusion: The study successfully developed and validated a composite scale (SES-C) for measuring the socioeconomic status in Lebanon, taking into account the complexities of the Lebanese context. The scale was found to be reliable and valid, and its results showed significant correlations with various factors such as older age, lower risk of chronic disease, and easy access to healthcare.

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1186/s12889-023-16531-9

Cites

Statistics

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

No references could be resolved yet.

Research works printed but not linked: 32

  1. Shavers VL. Measurement of socioeconomic status in health disparities research. J Natl Med Assoc. 2007;99(9):1013–23.
  2. Bell S. Socioeconomic Status and Study Abroad: Participation, Academic Performance, and Graduation. Educational Foundations & Leadership Theses & Dissertations. 2015; https://doi.org/10.25777/9rf7-7179. · DOI
  3. Marmot M, Friel S, Bell R, Houweling TA, Taylor S. Closing the gap in a generation: health equity through action on the social determinants of health. The Lancet. 2008;372(9650):1661–9. https://doi.org/10.1016/S0140-6736(08)61690-6. · DOI
  4. Boles DB. Socioeconomic status, a forgotten variable in lateralization development. Brain Cogn. 2011;76(1):52–7. https://doi.org/10.1016/j.bandc.2011.03.002. · DOI
  5. Steptoe A, Zaninotto P. Lower socioeconomic status and the acceleration of aging: An outcome-wide analysis. Proc Natl Acad Sci USA. 2020;117(26):14911–7. https://doi.org/10.1073/pnas.1915741117. · DOI
  6. Chetty R, Stepner M, Abraham S, Lin S, Scuderi B, Turner N, et al. The association between income and life expectancy in the United States, 2001–2014. JAMA. 2016;315(16):1750–66. https://doi.org/10.1001/jama.2016.4226. · DOI · Paper page
  7. Jakab Z, Marmot M. Social determinants of health in Europe. The Lancet. 2012;379(9811):103–5. https://doi.org/10.1016/S0140-6736(11)61511-0. · DOI
  8. Shafiei S, Yazdani S, Jadidfard MP, Zafarmand AH. Measurement components of socioeconomic status in health-related studies in Iran. BMC Res Notes. 2019;12(1):70. https://doi.org/10.1186/s13104-019-4101-y. · DOI
  9. Darin-Mattsson A, Fors S, Kåreholt I. Different indicators of socioeconomic status and their relative importance as determinants of health in old age. Int J Equity Health. 2017;16(1):173. https://doi.org/10.1186/s12939-017-0670-3. · DOI
  10. Haghdoost AA. Complexity of the socioeconomic status and its disparity as a determinant of health. Int J Prev Med. 2012;3(2):75–6.
  11. Psaki SR, Seidman JC, Miller M, Gottlieb M, Bhutta ZA, Ahmed T, et al. Measuring socioeconomic status in multicountry studies: results from the eight-country MAL-ED study. Popul Health Metrics. 2014;12(1):8. https://doi.org/10.1186/1478-7954-12-8. · DOI
  12. Mahdavian M, Safizadeh H. Measurement of socioeconomic status in Iran: a systematic review. Asian J Agricultural Ext Econ Sociol. 2015;6(1):1–15. https://doi.org/10.9734/AJAEES/2015/16756. · DOI
  13. Braveman PA, Cubbin C, Egerter S, Chideya S, Marchi KS, Metzler M, et al. Socioeconomic status in health researchone size does not fit all. JAMA. 2005;294(22):2879–88. https://doi.org/10.1001/jama.294.22.2879. · DOI
  14. Howe LD, Galobardes B, Matijasevich A, Gordon D, Johnston D, Onwujekwe O, et al. Measuring socio-economic position for epidemiological studies in low- and middle-income countries: a methods of measurement in epidemiology paper. Int J Epidemiol. 2012;41(3):871–86. https://doi.org/10.1093/ije/dys037. · DOI
  15. Majumder S. Socioeconomic status scales: Revised Kuppuswamy, BG Prasad, and Udai Pareekh’s scale updated for 2021. J Family Med Primary Care. 2021;10(11):3964–7. https://doi.org/10.4103/jfmpc.jfmpc_600_21. · DOI
  16. Fleifel M, Abi Farraj K. The Lebanese Healthcare Crisis: An Infinite Calamity. Cureus. 2022;14(5):e25367. https://doi.org/10.7759/cureus.25367. · DOI
  17. Shallal A, Lahoud C, Zervos M, Matar M. Lebanon is losing its front line. J Glob Health. 2021;11:03052. https://doi.org/10.7189/jogh.11.03052. · DOI
  18. Sacre H, Hamra R, Hassoun C, Hanna MLA, Ghossoub M, Jaber J, et al. Towards a national pharmaceutical strategy in Lebanon: Ensuring access to quality and safe medications for all. Pharmacy Educ. 2023;23(1):165–79. https://doi.org/10.46542/pe.2023.231.165179. · DOI
  19. Prawitz AD, Garman ET, Sorhaindo B, O’Neill B, Kim J, Drentea P. Incharge Financial Distress/Financial Well-Being Scale: Development, Administration, and Score Interpretation. Financial Counseling Planning. 2006;17:34–50. https://doi.org/10.1037/t60365-000. · DOI
  20. Kanyongo G. Determining the Correct Number of Components to Extract from a Principal Components Analysis: A Monte Carlo Study of The Accuracy of the Scree Plot. J Modern Applied Statistical Methods. 2005;4(1):13. https://doi.org/10.22237/jmasm/1114906380. · DOI
  21. Dunn TJ, Baguley T, Brunsden V. From alpha to omega: a practical solution to the pervasive problem of internal consistency estimation. British J Psychol (London, England: 1953). 2014;105(3):399–412. https://doi.org/10.1111/bjop.12046. · DOI
  22. Eriksson K, Lindvall J, Helenius O, Ryve A. Socioeconomic status as a multidimensional predictor of student achievement in 77 societies. Front Educ. 2021;6:731634. https://doi.org/10.3389/feduc.2021.731634. · DOI
  23. Avvisati F. The measure of socio-economic status in PISA: a review and some suggested improvements. Large-scale Assessments Educ. 2020;8(1):8. https://doi.org/10.1186/s40536-020-00086-x. · DOI · Paper page
  24. Geyer S, Hemström O, Peter R, Vågerö D. Education, income, and occupational class cannot be used interchangeably in social epidemiology. Empirical evidence against a common practice. J Epidemiol Community Health. 2006;60(9):804–10. https://doi.org/10.1136/jech.2005.041319. · DOI
  25. Bollen KA, Bauldry S. Three Cs in measurement models: causal indicators, composite indicators, and covariates. Psychol Methods. 2011;16(3):265–84. https://doi.org/10.1037/a0024448. · DOI
  26. Dew JP. Revisiting Financial Issues and Marriage. In: Xiao JJ (ed.) Handbook of Consumer Finance Research. Cham: Springer International Publishing; 2016. p. 281–290. https://doi.org/10.1007/978-3-319-28887-1_23. [Accessed 29 Jan 2023]. · DOI
  27. Edin K, Reed JM. Why Don’t They Just Get Married? Barriers to Marriage among the Disadvantaged. The Future of Children. 2005;15(2): 117–137. https://www.jstor.org/stable/3556566 · DOI
  28. Bucher A, Neubauer AB, Voss A, Oetzbach C. Together is better: higher committed relationships increase life satisfaction and reduce loneliness. J Happiness Stud. 2019;20(8):2445–69. https://doi.org/10.1007/s10902-018-0057-1. · DOI
  29. Mair FS, Jani BD. Emerging trends and future research on the role of socioeconomic status in chronic illness and multimorbidity. The Lancet Public Health. 2020;5(3):e128–9. https://doi.org/10.1016/S2468-2667(20)30001-3. · DOI
  30. McMaughan DJ, Oloruntoba O, Smith ML. Socioeconomic status and access to healthcare: interrelated drivers for healthy aging. Front Public Health. 2020;8:231. https://doi.org/10.3389/fpubh.2020.00231. · DOI
  31. Obeid S, Hallit S, Sacre H, Salameh P. Factors associated with the onset of smoking and alcohol consumption: a cross-sectional study among Lebanese adolescents in schools. Arch Pediatr. 2022;29(3):194–9. https://doi.org/10.1016/j.arcped.2022.01.002. · DOI
  32. Alaouie H, Branston JR, Bloomfield MJ, Salti N. The politics of pricing: the relative affordability of cigarettes in Lebanon during the 2019 financial crisis. Tobacco Prevention & Cessation. 2023;9(Supplement). https://doi.org/10.18332/tpc/162448. · DOI

Cited by

Sorted by citations

Metadata

Authors
Sacre, H., Haddad, C., Hajj, A., Zeenny, R. M., Akel, M., & Salameh, P.
Affiliations
  • Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban (LB)
  • Modern University for Business and Science (LB)
  • Saint Joseph University (LB)
  • American University of Beirut Medical Center (LB)
  • Lebanese University (LB)
Corresponding author
Haddad, Chadia
ORCID
Venue
BMC Public Health
Publisher
Springer Science and Business Media LLC
Published
2023-08-24
Volume
23
Issue
1
Pages
1619-1619
ISSN
1471-2458 (ISSN-L)
DOI
10.1186/s12889-023-16531-9
PMC
PMC10464400
OpenAlex
W4386142034
Cited by
41
References
0
Citations by year
2026: 16 · 2025: 16 · 2024: 8 · 2023: 1
FWCI
11.08
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Public Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Social Sciences › Health › Health disparities and outcomes
  • Social Sciences › Health › Public Health and Social Inequalities
  • Health Sciences › Nursing › Research and Theory › Health Education and Validation
Keywords
socioeconomic status, composite scale, scale development, scale validation, Lebanese adults, socio-economic crisis, health care access, chronic disease, household income, crowding index, financial well-being, educational attainment, Lebanon
MeSH terms
Correlation of Data, Adult, Alcohol Drinking, Child, Educational Status, Health Facilities, Humans, Social Class

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review