Agreement between area- and individual-level income measures in a population-based cohort

Implications for population health research

Datos Bibliográficos

ID15742252
AutoresEmmalin Buajitti (0000-0002-3194-7331, Public Health Ontario), Sabrina Chiodo (0000-0001-6722-1017, Public Health Ontario), Laura C Rosella (0000-0003-4867-869X, Public Health Ontario, autor de correspondencia)
Año2020
Volumen10
Páginas100553-100553
Fecha de publicación2020-02-04
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaSSM - Population Health (JOURNAL)
Identificadores de la revistaISSN: 2352-8273 • E-ISSN: 2352-8273
EditorialElsevier BV (PUBLISHER)
DOI10.1016/j.ssmph.2020.100553
PMID32072008
OpenAlexW3004933030
IdiomaEN
Citas recibidas10
Referencias citadas49

Socioeconomic status is an important determinant of health, the measurement of which is of great significance to population health research. However, individual-level socioeconomic factors are absent from much health administrative data, resulting in widespread use of area-level measures in their place. This study aims to clarify the role of individual- and area-level socioeconomic status in Ontario, Canada, through comparison of income measures. Using data from four cycles (2005-2012) of the Canadian Community Health Survey, we assessed concordance between individual- and area-level income quintiles using percent agreement and Kappa statistics. Individual-level characteristics were compared at baseline. Cumulative adult premature mortality was calculated for 5-years following interview. Rates were calculated separately for area-level and individual-level income, and jointly for each combination of income groups. Multivariable negative binomial models were fit to estimate associations between area- and individual-level income quintile and premature mortality after adjustment for basic demographics (age, sex, interview cycle) and key risk factors (alcohol, smoking, physical activity, and body mass index). Agreement between individual- and area-level income measures was low. Kappa statistics for same and similar (i.e. ±1 quintile) measures were 0.11 and 0.48, indicating low and moderate agreement, respectively. Socioeconomic disparities in premature mortality were greater for individual-level income than area-level income. When rates were stratified by both area- and individual-level income quintiles simultaneously, individual-level income gradients persisted within each area-level income group. The association between income and premature mortality was significant for both measures, including after full adjustment. Area-level socioeconomic status is an inappropriate proxy for missing individual-level data. The low agreement between area- and individual-level income measures and differences in demographic profile indicate that the two socioeconomic status measures do not capture the same population groups. However, our findings demonstrate that both individual- and area-level income measures are associated with premature mortality, and describe unique socioeconomic inequities

Concordance · Environmental health · Geography · Household income · Population · Socioeconomic status · Demography · Food Security and Health in Diverse Populations · Global Health Care Issues · Health disparities and outcomes · Medicine