The Future (History) of Socioeconomic Measurement and Implications for Improving Health Outcomes Among African Americans

Abstract

Socioeconomic status (SES) has powerful and complex impacts on health, and understanding the relationship between SES and health is essential for long-term improvements in the health of populations. In addition, in the United States, the impact of SES on health is inextricably intertwined with racial and ethnicity status and the historical development and maintenance of health disparities. Most of the literature documenting this relationship has focused on individual-level socioeconomic factors. There are sound theoretical reasons and some empirical support to suggest that socioeconomic resources at both individual and neighborhood levels have strong influences on health outcomes such as disease, disability, and mortality. However, these relationships have been inadequately examined to date. In this article, the term "ecological SES" will be used to denote SES at geographic group levels. As the United States attempts to achieve the goals of the Department of Health and Human Services' Healthy People 2010 program, understanding ecological SES and its impacts on health will be crucial. We review the theory, some of the empirical evidence, and likely future for the measurement and use of a broader approach to SES and offer a specific research paradigm for examining these issues. We focus in particular on one racial-ethnic group that experiences health disparity, that is, African Americans. We use our ongoing project investigating physical frailty in urban African Americans to illustrate the importance of a multilevel approach to understanding the impacts of socioeconomic resources on health and the potential implications for efforts to prevent or reverse frailty.

Socioeconomic Status and Race are both Independently associated with Increased Hospitalization Rate among Crohn’s Disease Patients

“…Analysis by income and poverty level displayed the trend that patients of greater income are less hospitalized for a CD-related event. Socioeconomic factors are most frequently implicated in the disparities seen in US health populations 15,16 . For example, people of lower SES are less likely to obtain needed transportation for disease management.…”

¿Cómo se ha medido la posición social en investigación en salud?: una revisión de la literatura internacional

“…Las investigaciones en salud con diseños ecológicos han sido valiosas, en especial como una primera aproximación cuando no se cuenta con información a nivel individual. Sin embargo, algunos autores han reconocido que la comprensión integral de la relación entre PS y salud requiere incorporar dimensiones contextuales además del nivel individual (57). Dentro de las escalas agregadas de medición de PS destacan los índices de deprivación socioeconómica (pobreza) según área, en particular los índices de deprivación de Jarman (58) y de Townsend (59), aunque también hay otras escalas menos utilizadas, como la de Carstairs y la de Bredline Britain (11), así como la denominada línea de pobreza (10,11,58,59).…”

Fall Prevention: Core Characteristics and Practical Interventions

“…There are almost no data regarding these issues in population-based samples of middle-aged persons and longitudinal studies of which I am aware that prospectively examine risk factors for falls and worsening fear of falling among representative samples of African Americans. In addition, a comprehensive theoretical approach to understanding falling and fear of falling should include the social and environmental circumstances of adults (Andresen & Miller, 2005). These factors have not been examined in longitudinal studies.…”