Use of proxy measures in estimating socioeconomic inequalities in malaria prevalence

Somi, Masha F.; Butler, James R.G.; Vahid, Farshid; Njau, Joseph; Kachur, S. Patrick; Abdulla, Salim

doi:10.1111/j.1365-3156.2008.02009.x

Cited by 22 publications

(37 citation statements)

References 22 publications

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“…Within the health sciences literature, there is a growing discussion about the difficulties in assessing socioeconomic status in various cultural settings, and the impact of this problem on analyses of variability in health status (Braveman et al, 2005;Shavers, 2007;Somi et al, 2008). Food insecurity studies demonstrate that qualitative data collected from ethnographic interviews can be operationalized in ways that accurately assess access subjects' to nutritional resources (Coates et al, 2006).…”

Section: Statistical Analysesmentioning

confidence: 99%

Adult health outcomes and their implications for experiences of childhood nutritional stress in Jamaica

Nelson

2009

American J Hum Biol

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With insights from the developmental origins of health and disease paradigm (DOHaD), this study explores the impact of childhood nutritional stress on adult health outcomes in Jamaica. Jamaica experienced a lengthy period of political and economic instability beginning in the postcolonial period of the early 1960s. This study tests whether decreased government spending on public resources and limited access to imported food products during the early postcolonial period will be reflected in increased adiposity and body mass index among Jamaican adults. Ethnographic and anthropometric data were collected from individuals born between 1958 and 1988. Variability in health outcomes was assessed using Z-score values for body mass index and summed skinfold thickness measures. Age was employed as both a continuous and categorical independent variable. In partial correlation models controlling for economic status, body mass index values and summed skinfold thickness increased with age. Birth cohort and gender effects were also apparent. Women born between 1959 and 1968 had higher body mass index Z-score values than younger women. Both men and women born between 1959 and 1968 had significantly higher skinfold thickness measures than younger individuals. Individuals born between 1959 and 1968 were children during the immediate postcolonial era in Jamaica. Experiences of nutritional stress during critical developmental periods may have contributed to the observed age-related increases in adipose tissue and body mass index values. This study informs our understanding of the ways that fluctuations in the sociopolitical environment during development can mediate and contribute to poor adult health outcomes.

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Section: Statistical Analysesmentioning

confidence: 99%

Adult health outcomes and their implications for experiences of childhood nutritional stress in Jamaica

Nelson

2009

American J Hum Biol

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“…38 The one previous comparison of indicators for measuring socioeconomic inequalities in malaria risk found that the wealth index was a reasonable alternative to consumption in rural Tanzania. 28 Although there is a paucity of underlying theory to guide the choice of included variables in wealth indices, 10 the inclusion of assets directly associated with the outcome of interest may increase the observed socioeconomic inequalities in health. 12 Furthermore, variables often included in the wealth index, such as house type, are sometimes evaluated independently as malaria risk factors.…”

Section: Discussionmentioning

confidence: 99%

“…However, a higher score in both the consumption and wealth index was associated with a reduced risk of malaria infection, indicating that the wealth index was a reasonable empirical and logistical alternative to consumption in that context. 28 In this study, we evaluate the agreement between four indicators of SEP and explore how the risk of malaria in children varies with these indicators in Nagongera, rural Uganda. The four indicators compared are 1) two wealth indices derived from PCA, 2) income, 3) occupation, and 4) female caregiver's education.…”

Section: Introductionmentioning

confidence: 99%

“…14,[25][26][27] However, to our knowledge, only one study has previously evaluated indicators for measuring socioeconomic inequalities in relation to malaria risk. 28 In that study, three indices were developed using data from 25 Tanzanian villages: a consumption index and two wealth indices derived from principal component analysis (PCA). Little difference was found between household rankings from the two wealth indices while a weak relationship was found between the wealth index and consumption index, with the household rankings based on PCA being less discriminatory than those based on consumption.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Measuring Socioeconomic Inequalities in Relation to Malaria Risk: A Comparison of Metrics in Rural Uganda

Tusting¹,

Rek²,

Arinaitwe³

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. Socioeconomic position (SEP) is an important risk factor for malaria, but there is no consensus on how to measure SEP in malaria studies. We evaluated the relative strength of four indicators of SEP in predicting malaria risk in Nagongera, Uganda. A total of 318 children resident in 100 households were followed for 36 months to measure parasite prevalence routinely every 3 months and malaria incidence by passive case detection. Household SEP was determined using: 1) two wealth indices, 2) income, 3) occupation, and 4) education. Wealth Index I (reference) included only asset ownership variables. Wealth Index II additionally included food security and house construction variables, which may directly affect malaria. In multivariate analysis, only Wealth Index II and income were associated with the human biting rate, only Wealth Indices I and II were associated with parasite prevalence, and only caregiver's education was associated with malaria incidence. This is the first evaluation of metrics beyond wealth and consumption indices for measuring the association between SEP and malaria. The wealth index still predicted malaria risk after excluding variables directly associated with malaria, but the strength of association was lower. In this setting, wealth indices, income, and education were stronger predictors of socioeconomic differences in malaria risk than occupation.

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“…A minority view holds that asset-based measures are in fact superior to expenditure based measures of SEP; [17] with others advocating a middle position. Somi et al, for instance, argued that both expenditure measures and asset-based indices should be treated as legitimate proxies of SEP, given that SEP is a latent variable that cannot be directly observed [18]. In a recent, significant (though not fully comprehensive (p.883)) review of socio-economic measures in low and middle income countries, the authors concluded that the research question, the setting, and the available resources needed to guide the choice of approach to the measurement of SEP [19].…”

Section: Introductionmentioning

confidence: 99%

A novel nonparametric item response theory approach to measuring socioeconomic position: a comparison using household expenditure data from a Vietnam health survey, 2003

Reidpath

Ahmadi

2014

Emerg Themes Epidemiol

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BackgroundMeasures of household socio-economic position (SEP) are widely used in health research. There exist a number of approaches to their measurement, with Principal Components Analysis (PCA) applied to a basket of household assets being one of the most common. PCA, however, carries a number of assumptions about the distribution of the data which may be untenable, and alternative, non-parametric, approaches may be preferred. Mokken scale analysis is a non-parametric, item response theory approach to scale development which appears never to have been applied to household asset data. A Mokken scale can be used to rank order items (measures of wealth) as well as households. Using data on household asset ownership from a national sample of 4,154 consenting households in the World Health Survey from Vietnam, 2003, we construct two measures of household SEP. Seventeen items asking about assets, and utility and infrastructure use were used. Mokken Scaling and PCA were applied to the data. A single item measure of total household expenditure is used as a point of contrast.ResultsAn 11 item scale, out of the 17 items, was identified that conformed to the assumptions of a Mokken Scale. All the items in the scale were identified as strong items (Hi > .5). Two PCA measures of SEP were developed as a point of contrast. One PCA measure was developed using all 17 available asset items, the other used the reduced set of 11 items identified in the Mokken scale analaysis. The Mokken Scale measure of SEP and the 17 item PCA measure had a very high correlation (r = .98), and they both correlated moderately with total household expenditure: r = .59 and r = .57 respectively. In contrast the 11 item PCA measure correlated moderately with the Mokken scale (r = .68), and weakly with the total household expenditure (r = .18).ConclusionThe Mokken scale measure of household SEP performed at least as well as PCA, and outperformed the PCA measure developed with the 11 items used in the Mokken scale. Unlike PCA, Mokken scaling carries no assumptions about the underlying shape of the distribution of the data, and can be used simultaneous to order household SEP and items. The approach, however, has not been tested with data from other countries and remains an interesting, but under researched approach.

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Use of proxy measures in estimating socioeconomic inequalities in malaria prevalence

Cited by 22 publications

References 22 publications

Adult health outcomes and their implications for experiences of childhood nutritional stress in Jamaica

Adult health outcomes and their implications for experiences of childhood nutritional stress in Jamaica

Measuring Socioeconomic Inequalities in Relation to Malaria Risk: A Comparison of Metrics in Rural Uganda

A novel nonparametric item response theory approach to measuring socioeconomic position: a comparison using household expenditure data from a Vietnam health survey, 2003

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