142nd APHA Annual Meeting and Exposition

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Validating an index of community-level socioeconomic composition for global health research

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 8:30 AM - 8:42 AM

Shivani Patel, PhD, MPH , Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
Susan Sherman, PhD, MPH , Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Parul Christian, DrPH , International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Joanne Katz, ScD , Department of Health, Johns Hopkins Bloomberg School of Public Health, Baltimore
Subarna Khatry, MBBS; DOMS; FRCS , Nepal Nutrition Invervention Project-Sarlahi, Kathmandu, Nepal
Steven LeClerq, BA , International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
James Tielsch, PhD , Global Health, George Washington University School of Public Health and Health Services, Washington DC, DC
Despite increasing recognition that community-level socioeconomic factors are critical to individual health outcomes globally, guidance on their measurement remains limited in resource-constrained settings. We outline the steps needed to develop and validate a theory-based, multidimensional index of community-level socioeconomic composition using information that is often available in global community-based studies. Our study population consisted of a cohort of 1822 children aged 7 to 9 years and their households in the Southern plains of Nepal. We conducted a principal components analysis of indicators describing human and social capital to construct a community socioeconomic composition index (CSCI) using census data for the 30 communities in which children resided. We validated the index by testing the theoretical prediction that residents of communities with higher capital would have an advantage in accruing more future capital (infrastructural and household assets) and achieving better health (child nutritional status). In ecological analysis, the CSCI was positively correlated with validation measures (r=.67, .85, .54, and .58 for community infrastructure index, household asset index, child height-for-age z-score, and child weight-for-age z-score, respectively). In multilevel analysis, +1SD of the CSCI was associated with + 0.14SD of the household asset index (p<.01). These results suggest that an exclusively census-based strategy to measure socioeconomic composition has construct validity in this setting. Our approach to measuring community-level socioeconomic composition may be feasibly reproduced in other resource-constrained settings where census data are available, potentially expanding the scope of place and health research globally.

Learning Areas:

Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe why community-level socioeconomic status matters in global health Assess community-level socioeconomic status in global settings quantitatively Analyze differences in health outcomes related to community-level socioeconomic status

Keyword(s): Community-Based Health, Poverty

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conducted my doctoral research in the Department of Epidemiology at the Johns Hopkins School of Public Health on the topic of measuring community-level socioeconomic composition and it association with health in Nepal. My scientific interests include utilizing existing data sources to answer social epidemiologic questions in low-resource settings.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.