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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Measuring socioeconomic status in multicountry studies: Results from the eight-country MAL-ED study
Population Health Metrics, Volume 12, No. 1, Article 8, Year 2014
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Description
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.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC4234146/bin/1478-7954-12-8-S1.doc
Authors & Co-Authors
Psaki, Stephanie R.
United States, Bethesda
National Institutes of Health Nih
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Seidman, Jessica C.
United States, Bethesda
National Institutes of Health Nih
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Miller, Mark A.
United States, Bethesda
National Institutes of Health Nih
Gottlieb, Michael
United States, Bethesda
National Institutes of Health Nih
Bhutta, Zulfiqar A.
Pakistan, Karachi
The Aga Khan University
Ahmed, Tahmeed J.
Bangladesh
International Centers for Diarrheal Disease Research
Shamsir Ahmed, Abul Mansur
Bangladesh
International Centers for Diarrheal Disease Research
Bessong, Pascal Obong
South Africa, Thohoyandou
University of Venda
John, Sushil Mathew
India, Vellore
Christian Medical College, Vellore
Kang, Gagandeep
India, Vellore
Christian Medical College, Vellore
Kosek, Margaret N.
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Moreira Lima, Aldo Ângelo
Brazil, Fortaleza
Universidade Federal do Ceará
Shrestha, Prakash Sunder
Nepal, Kathmandu
Tribhuvan University
Svensen, Erling
Norway, Bergen
Universitetet I Bergen
Tanzania, Mbulu
Haydom Lutheran Hospital
Checkley, William N.
United States, Bethesda
National Institutes of Health Nih
United States, Baltimore
Johns Hopkins Bloomberg School of Public Health
Statistics
Citations: 196
Authors: 15
Affiliations: 10
Identifiers
Doi:
10.1186/1478-7954-12-8
e-ISSN:
14787954
Research Areas
Environmental
Health System And Policy
Maternal And Child Health
Study Design
Cross Sectional Study
Study Approach
Quantitative
Participants Gender
Male