Global Strategy Lab, Dahdaleh Institute for Global Health Research, Faculty of Health, York University, 4700 Keele Street, Dahdaleh Building 2120, Toronto, ON, M3J 1P3, Canada.
School of Global Health, Faculty of Health, York University, Toronto, Canada.
Sci Rep. 2024 Feb 15;14(1):3851. doi: 10.1038/s41598-024-54170-1.
There has been no systematic comparison of how the three most common measures to quantify household SES-income, consumption, and asset indices-could impact the magnitude of health inequalities. Microdata from 22 Living Standards Measurement Study surveys were compiled and concentration indices, relative indices of inequality, and slope indices of inequality were calculated for underweight, stunting, and child deaths using income, consumption, asset indices, and hybrid predicted income. Meta-analyses of survey year subgroups (pre-1995, 1995-2004, and post-2004), outcomes (child deaths, stunting, and underweight), and World Bank country-income status (low, low-middle, and upper-middle) were then conducted. Asset indices and the related hybrid income proxy result in the largest magnitudes of health inequalities for all 12 overall outcomes, as well as most country-income and survey year subgroupings. There is no clear trend of health inequality magnitudes changing over time, but magnitudes of health inequality may increase as country-income levels increase. There is no significant difference between relative and absolute inequality measures, but the hybrid predicted income measure behaves more similarly to asset indices than the household income it is supposed to model. Health inequality magnitudes may be affected by the choice of household SES measure and should be studied in further detail.
目前还没有系统地比较三种最常见的衡量家庭社会经济地位的方法（收入、消费和资产指数）如何影响健康不平等的程度。我们汇集了来自 22 项生活水平衡量调查的数据，并使用收入、消费、资产指数和混合预测收入计算了体重不足、发育迟缓以及儿童死亡的集中指数、相对不平等指数和不平等斜率指数。然后对调查年份分组（1995 年前、1995-2004 年和 2004 年后）、结果（儿童死亡、发育迟缓以及体重不足）和世界银行国家收入状况（低收入、中低收入和中高收入）进行了荟萃分析。对于所有 12 项总体结果以及大多数国家收入和调查年份分组，资产指数和相关的混合收入代理结果导致了最大的健康不平等程度。健康不平等程度随时间变化没有明显趋势，但随着国家收入水平的提高，健康不平等程度可能会增加。相对不平等和绝对不平等指标之间没有显著差异，但混合预测收入指标的行为与资产指数更相似，而不是它所模拟的家庭收入。健康不平等程度可能受家庭社会经济地位衡量标准选择的影响，应进一步详细研究。
