Combining education and income into a socioeconomic position score for use in studies of health inequalities
Abstract Background In studies of social inequalities in health, there is no consensus on the best measure of socioeconomic position (SEP). Moreover, subjective indicators are increasingly used to measure SEP. The aim of this paper was to develop a composite score for SEP based on weighted combinati...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-05-01
|
| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12889-022-13366-8 |
| _version_ | 1818203817815048192 |
|---|---|
| author | Marie Hella Lindberg Gang Chen Jan Abel Olsen Birgit Abelsen |
| author_facet | Marie Hella Lindberg Gang Chen Jan Abel Olsen Birgit Abelsen |
| author_sort | Marie Hella Lindberg |
| collection | DOAJ |
| description | Abstract Background In studies of social inequalities in health, there is no consensus on the best measure of socioeconomic position (SEP). Moreover, subjective indicators are increasingly used to measure SEP. The aim of this paper was to develop a composite score for SEP based on weighted combinations of education and income in estimating subjective SEP, and examine how this score performs in predicting inequalities in health-related quality of life (HRQoL). Methods We used data from a comprehensive health survey from Northern Norway, conducted in 2015/16 (N = 21,083). A composite SEP score was developed using adjacent-category logistic regression of subjective SEP as a function of four education and four household income levels. Weights were derived based on these indicators’ coefficients in explaining variations in respondents’ subjective SEP. The composite SEP score was further applied to predict inequalities in HRQoL, measured by the EQ-5D and a visual analogue scale. Results Education seemed to influence SEP the most, while income added weight primarily for the highest income category. The weights demonstrated clear non-linearities, with large jumps from the middle to the higher SEP score levels. Analyses of the composite SEP score indicated a clear social gradient in both HRQoL measures. Conclusions We provide new insights into the relative contribution of education and income as sources of SEP, both separately and in combination. Combining education and income into a composite SEP score produces more comprehensive estimates of the social gradient in health. A similar approach can be applied in any cohort study that includes education and income data. |
| first_indexed | 2024-12-12T03:31:23Z |
| format | Article |
| id | doaj.art-79885bc2aec94cbb81d0e591ecfd1430 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-12T03:31:23Z |
| publishDate | 2022-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-79885bc2aec94cbb81d0e591ecfd14302022-12-22T00:39:55ZengBMCBMC Public Health1471-24582022-05-0122111110.1186/s12889-022-13366-8Combining education and income into a socioeconomic position score for use in studies of health inequalitiesMarie Hella Lindberg0Gang Chen1Jan Abel Olsen2Birgit Abelsen3Department of Community Medicine, UiT – The Arctic University of NorwayCentre for Health Economics, Monash UniversityDepartment of Community Medicine, UiT – The Arctic University of NorwayDepartment of Community Medicine, UiT – The Arctic University of NorwayAbstract Background In studies of social inequalities in health, there is no consensus on the best measure of socioeconomic position (SEP). Moreover, subjective indicators are increasingly used to measure SEP. The aim of this paper was to develop a composite score for SEP based on weighted combinations of education and income in estimating subjective SEP, and examine how this score performs in predicting inequalities in health-related quality of life (HRQoL). Methods We used data from a comprehensive health survey from Northern Norway, conducted in 2015/16 (N = 21,083). A composite SEP score was developed using adjacent-category logistic regression of subjective SEP as a function of four education and four household income levels. Weights were derived based on these indicators’ coefficients in explaining variations in respondents’ subjective SEP. The composite SEP score was further applied to predict inequalities in HRQoL, measured by the EQ-5D and a visual analogue scale. Results Education seemed to influence SEP the most, while income added weight primarily for the highest income category. The weights demonstrated clear non-linearities, with large jumps from the middle to the higher SEP score levels. Analyses of the composite SEP score indicated a clear social gradient in both HRQoL measures. Conclusions We provide new insights into the relative contribution of education and income as sources of SEP, both separately and in combination. Combining education and income into a composite SEP score produces more comprehensive estimates of the social gradient in health. A similar approach can be applied in any cohort study that includes education and income data.https://doi.org/10.1186/s12889-022-13366-8Socioeconomic positionSocioeconomic statusHealth inequalitiesHealth-related quality of lifeComposite indicator |
| spellingShingle | Marie Hella Lindberg Gang Chen Jan Abel Olsen Birgit Abelsen Combining education and income into a socioeconomic position score for use in studies of health inequalities BMC Public Health Socioeconomic position Socioeconomic status Health inequalities Health-related quality of life Composite indicator |
| title | Combining education and income into a socioeconomic position score for use in studies of health inequalities |
| title_full | Combining education and income into a socioeconomic position score for use in studies of health inequalities |
| title_fullStr | Combining education and income into a socioeconomic position score for use in studies of health inequalities |
| title_full_unstemmed | Combining education and income into a socioeconomic position score for use in studies of health inequalities |
| title_short | Combining education and income into a socioeconomic position score for use in studies of health inequalities |
| title_sort | combining education and income into a socioeconomic position score for use in studies of health inequalities |
| topic | Socioeconomic position Socioeconomic status Health inequalities Health-related quality of life Composite indicator |
| url | https://doi.org/10.1186/s12889-022-13366-8 |
| work_keys_str_mv | AT mariehellalindberg combiningeducationandincomeintoasocioeconomicpositionscoreforuseinstudiesofhealthinequalities AT gangchen combiningeducationandincomeintoasocioeconomicpositionscoreforuseinstudiesofhealthinequalities AT janabelolsen combiningeducationandincomeintoasocioeconomicpositionscoreforuseinstudiesofhealthinequalities AT birgitabelsen combiningeducationandincomeintoasocioeconomicpositionscoreforuseinstudiesofhealthinequalities |