Socioeconomic indicators in epidemiologic research: A practical example from the LIFEPATH study

Abstract

BackgroundSeveral social indicators have been used in epidemiological research to describe socioeconomic position (SEP) of people in societies. Among SEP indicators, those more frequently used are education, occupational class and income. Differences in the incidence of several health outcomes have been reported consistently, independently from the indicator employed. Main objectives of the study were to present the socioeconomic classifications of the social indicators which will be employed throughout the LIFEPATH project and to compare social gradients in all-cause mortality observed in the participating adult cohorts using the different SEP indicators.MethodsInformation on the available social indicators (education, own and father’s occupational class, income) from eleven adult cohorts participating in LIFEPATH was collected and harmonized. Mortality by SEP for each indicator was estimated by Poisson regression on each cohort and then evaluated using a meta-analytical approach.ResultsIn the meta-analysis, among men mortality was significantly inversely associated with both occupational class and education, but not with father’s occupational class; among women, the increase in mortality in lower social strata was smaller than among men and, except for a slight increase in the lowest education category, no significant differences were found.ConclusionsAmong men, the proposed three-level classifications of occupational class and education were found to predict differences in mortality which is consistent with previous research. Results on women suggest that classifying them through their sole SEP, without considering that of their partners, may imply a misclassification of their social position leading to attenuation of mortality differences.

Measuring Child Socio-Economic Position in Birth Cohort Research: The Development of a Novel Standardized Household Income Indicator

“…Other cross-country comparable composite SEP indicators have been proposed in the epidemiological literature, although none is focused on the household income. Among these the European Socio-Economic Classification is an occupational based index used as a SEP indicator in the H2020 LIFEPATH project [13]; the European Deprivation Index [26] is an ecological indicator constructed from the EUSILC survey and therefore in principle applicable to all European studies, even if the neighborhood/ecological deprivation likely affects health outcome through different mechanisms than the individual SEP. The household disposable income is one of the most important individual single indicators of child SEP, but is difficult to obtain through questionnaires; for example, in this study household income was available in all cohorts except NINFEA, but only in ELFE was assessed thoroughly.…”

“…Maternal education is often used as the only proxy of child SEP [5][6][7][8][9], as it is easy to collect, even retrospectively, it is quite stable over time, it is less affected by childbearing than occupation and income, and it is fairly comparable across different populations and countries, although not across different generations [10]. However, each single indicator (e.g., maternal education, occupation, income) captures different, likely correlated, dimensions of the child SEP [4,8,9,[11][12][13]. Using maternal education only, which can be considered as a measure of intellectual resources, might therefore not be the best choice for some research questions (e.g., when studying an outcome strongly influenced by economic/material resources), might be insufficient to control for confounding when SEP is a strong potential confounder of an exposure-outcome relationship, and cannot capture individual changes in SEP over time [10].…”

Do conceptualisations of health differ across social strata? A concept mapping study among lay people

“…In studies on health inequalities, education is a frequently used indicator of adult SES. 19 It is strongly associated with occupational level and income, but has the advantage of being available for each individual, also, for example, for those without a paid job. Although different indicators might indicate different aspects of someone’s position, 19 we do not expect our results to be biased by the choice for this indicator, as the conceptualisation of the concept mapping groups reflect aspects closely related to educational level (such as autonomy), and aspects related to income and occupational level (eg, having access to healthcare or living in a healthy environment).…”

Socioeconomic status, non-communicable disease risk factors, and walking speed in older adults: multi-cohort population based study

“…In the LIFEPATH Consortium, we used a predefined harmonised definition of socioeconomic status, as described in previous papers. 30 31 We used information on several social indicators available in the participating cohort studies—education, own and father’s occupational class, and income. For adults, we assigned socioeconomic status to cohort members using information on the last known occupational title at study enrolment.…”