Much has been written about the measurement of socio-economic position (SEP) in high-income countries (HIC). Less has been written for an epidemiology, health systems and public health audience about the measurement of SEP in low- and middle-income countries (LMIC). The social stratification processes in many LMIC-and therefore the appropriate measurement tools-differ considerably from those in HIC. Many measures of SEP have been utilized in epidemiological studies; the aspects of SEP captured by these measures and the pathways through which they may affect health are likely to be slightly different but overlapping. No single measure of SEP will be ideal for all studies and contexts; the strengths and limitations of a given indicator are likely to vary according to the specific research question. Understanding the general properties of different indicators, however, is essential for all those involved in the design or interpretation of epidemiological studies. In this article, we describe the measures of SEP used in LMIC. We concentrate on measures of individual or household-level SEP rather than area-based or ecological measures such as gross domestic product. We describe each indicator in terms of its theoretical basis, interpretation, measurement, strengths and limitations. We also provide brief comparisons between LMIC and HIC for each measure.

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Measuring socio-economic position for epidemiological studies in low- and middle-income countries: a methods of measurement in epidemiology paper

We argue that support for parties of the radical right and left can usefully be understood as a problem of social integration—an approach that brings together economic and cultural explanations for...

Populism as a Problem of Social Integration

The MacArthur Scale of Subjective Social Status intend to measure the subjective social status using a numbered stepladder image This study investigated the reliability of the MacArthur scale in a subsample of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) Three scales were employed using different references: 1) the overall socioeconomic position; 2) the socioeconomic situation of the participant’s closer community; 3) the workplace as a whole A total of 245 of the ELSA participants from six states were involved They were interviewed twice by the same person within an interval of seven to fourteen days The reliability of the scale was assessed with weighted Kappa statistics and intraclass correlation coefficient (ICC), with their respective 95% confidence interval (CI) Kappa values were 062(058 to 064) for the society ladder; 058(056 to 061) for the community-related ladder; and 067(066 to 072) for the work-related ladder The ICC ranged from 075 for the work ladder to 064 for the community ladder These values differed slightly according to the participants’ age, sex and education category The three ladders showed good stability in the test-retest, except the community ladder that showed moderate stability Because the social structure in Brazil is rapidly changing, future qualitative and longitudinal studies are needed to confirm and understand the construct underlying the MacArthur Scale in the country

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Reliability of the MacArthur scale of subjective social status - Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

This review provides a critical appraisal of the measurement of students’ social class and socioeconomic status (SES) in the context of widening higher education participation. Most assessments of social class and SES in higher education have focused on objective measurements based on the income, occupation, and education of students’ parents, and they have tended to overlook diversity among students based on factors such as age, ethnicity, indigeneity, and rurality. However, recent research in psychology and sociology has stressed the more subjective and intersectional nature of social class. The authors argue that it is important to consider subjective self-definitions of social class and SES alongside more traditional objective measures. The implications of this dual measurement approach for higher education research are discussed.

“I Am Working-Class”: Subjective Self-Definition as a Missing Measure of Social Class and Socioeconomic Status in Higher Education Research

While the association between inadequate health literacy and adverse health outcomes has been well documented, less is known about the impact of health literacy on health perceptions, such as perceptions of control over health, and preventive health behaviors. We identified a subsample of participants (N = 707) from the Health and Retirement Study (HRS), a nationally representative sample of older adults, who participated in health literacy testing. Self-reported health literacy was measured with a literacy screening question, and objective health literacy with a summed score of items from the Test of Functional Health Literacy. We compared answers on these items to those related to participation in health behaviors such as cancer screening, exercise, and tobacco use, as well as self-referencing health beliefs. In logistic regression models adjusted for gender, education, race, and age, participants with adequate self-reported health literacy (compared to poorer levels of health literacy) had greater odds of participation in mammography within the last 2 years (Odds ratio [OR] = 2.215, p = 0.01) and participation in moderate exercise two or more times per week (OR = 1.512, p = 0.03). Participants with adequate objective health literacy had reduced odds of participation in monthly breast self-exams (OR = 0.369, p = 0.004) and reduced odds of current tobacco use (OR = 0.456, p = 0.03). In adjusted linear regression analyses, self-reported health literacy made a small but significant contribution to explaining perceived control of health (β 0.151, p = <0.001) and perceived social standing (β 0.112, p = 0.002). In a subsample of older adult participants of the HRS, measures of health literacy were positively related to several health promoting behaviors and health-related beliefs and non-use of breast self-exams, a screening behavior of questionable benefit. These relationships varied however, between self-reported and objectively-measured health literacy. Further investigation into the specific mechanisms that lead higher literacy people to pursue health promoting actions appears clearly warranted.

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Herzig Lilli

Papers

MacArthur scale of subjective social status.