Narla Nirmala P, Pardo-Crespo Maria R, Beebe Timothy J, Sloan Jeff, Yawn Barbara, Williams Arthur R, Juhn Young J
J Health Care Poor Underserved. 2015 Nov;26(4):1157-72. doi: 10.1353/hpu.2015.0122.
Area-level socioeconomic status (SES) measures have been used as a proxy in child health research when individual SES measures are lacking, yet little is known about their validity in an urban setting. We assessed agreement between census block-group and individual-level SES measures obtained from a caregiver telephone survey in Jackson County, Missouri. Associations with prevalence of childhood overweight (OW), low birth weight (LBW), and household smoking exposure were examined using logistic regression models. Seven hundred eighty-one households were surveyed: 49% male, 76% White, mean child age 9.4 years. We found misclassification rates of 20-35% between individual vs. area-level measures of education and income; Kappa indices ranged from 0.26-0.36 indicating poor agreement. Both SES measures showed an inverse association with LBW and smoking exposure. Area-level SES measures may reflect a construct inclusive of neighborhood resources; routine substitution of these measures should be interpreted with caution, despite similar correlations with health outcomes.
当缺乏个体社会经济地位（SES）指标时，地区层面的社会经济地位指标已被用作儿童健康研究中的替代指标，但对于其在城市环境中的有效性知之甚少。我们评估了密苏里州杰克逊县从照顾者电话调查中获得的普查街区组层面和个体层面SES指标之间的一致性。使用逻辑回归模型研究了与儿童超重（OW）、低出生体重（LBW）患病率以及家庭吸烟暴露的关联。共调查了781户家庭：49%为男性，76%为白人，儿童平均年龄9.4岁。我们发现，在教育和收入的个体层面与地区层面指标之间，误分类率为20%至35%；卡帕指数范围为0.26至0.36，表明一致性较差。两种SES指标均显示与低出生体重和吸烟暴露呈负相关。地区层面的SES指标可能反映了一个包含邻里资源的结构；尽管与健康结果有相似的相关性，但在常规情况下替换这些指标时应谨慎解释。
