Measuring socioeconomic status in multicountry studies: results from the eight-country MAL-ED study

作者：Stephanie R Psaki, Jessica C. Seidman, Mark Miller, Michael Gottlieb, Zulfiqar A Bhutta, Tahmeed Ahmed, AM Shamsir Ahmed, Pascal Bessong, Sushil John, Gagandeep Kang, Margaret Kosek, Aldo Â. M. Lima, Prakash Shrestha, Erling Svensen, William Checkley, MAL-ED Network Investigators · 发表于：Population Health Metrics · 年份：2014 · DOI：10.1186/1478-7954-12-8 · 被引用次数：283 · 研究领域：Health disparities and outcomes、Health, Environment, Cognitive Aging、Food Security and Health in Diverse Populations

BACKGROUND: There is no standardized approach to comparing socioeconomic status (SES) across multiple sites in epidemiological studies. This is particularly problematic when cross-country comparisons are of interest. We sought to develop a simple measure of SES that would perform well across diverse, resource-limited settings. METHODS: A cross-sectional study was conducted with 800 children aged 24 to 60 months across eight resource-limited settings. Parents were asked to respond to a household SES questionnaire, and the height of each child was measured. A statistical analysis was done in two phases. First, the best approach for selecting and weighting household assets as a proxy for wealth was identified. We compared four approaches to measuring wealth: maternal education, principal components analysis, Multidimensional Poverty Index, and a novel variable selection approach based on the use of random forests. Second, the selected wealth measure was combined with other relevant variables to form a more complete measure of household SES. We used child height-for-age Z-score (HAZ) as the outcome of interest. RESULTS: Mean age of study children was 41 months, 52% were boys, and 42% were stunted. Using cross-validation, we found that random forests yielded the lowest prediction error when selecting assets as a measure of household wealth. The final SES index included access to improved water and sanitation, eight selected assets, maternal education, and household income (the WAM...