Title
Measuring socioeconomic status in multicountry studies: Results from the eight-country MAL-ED study
Date Issued
21 March 2014
Access level
open access
Resource Type
journal article
Author(s)
Psaki S.R.
Seidman J.C.
Miller M.
Gottlieb M.
Bhutta Z.A.
Ahmed T.
Ahmed A.M.S.
Bessong P.
John S.M.
Kang G.
Lima A.
Shrestha P.
Svensen E.
Checkley W.
Publisher(s)
BioMed Central Ltd.
Abstract
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 WAMI index). A 25% difference in the WAMI index was positively associated with a difference of 0.38 standard deviations in HAZ (95% CI 0.22 to 0.55).Conclusions: Statistical learning methods such as random forests provide an alternative to principal components analysis in the development of SES scores. Results from this multicountry study demonstrate the validity of a simplified SES index. With further validation, this simplified index may provide a standard approach for SES adjustment across resource-limited settings. © 2014 Psaki et al.; licensee BioMed Central Ltd.
Volume
12
Issue
1
Language
English
OCDE Knowledge area
Nutrición, Dietética
Scopus EID
2-s2.0-84897986964
Source
Population Health Metrics
ISSN of the container
14787954
Sponsor(s)
The Interactions of Malnutrition & Enteric Infections: Consequences for Child Health and Development (MAL-ED) study is carried out as a collaborative project and supported by the Bill & Melinda Gates Foundation, the Foundation for the NIH, and the National Institutes of Health/Fogarty International Center. The authors thank the staff and participants of the MAL-ED Network Project for their important contributions. William Checkley was further supported by a Pathway to Independence Award (R00HL096955) from the National Heart, Lung and Blood Institute, National Institutes of Health.
Sources of information: Directorio de Producción Científica Scopus