TY - JOUR
T1 - Assessment of a national health interview survey-based method of measuring community socioeconomic status
AU - Yabroff, K. Robin
AU - Gordis, Leon
N1 - Funding Information:
Supported in part by the National Cancer Institute grant # T32 CA09314 (Dr. Yabroff).
PY - 2003/11
Y1 - 2003/11
N2 - PURPOSE: Increasingly researchers are interested in assessing the role of community socioeconomic status (SES) in poor health outcomes, above and beyond the influence of low individual SES. However, the feasibility of conducting these multi-level studies is often limited by restrictions on release of confidential identifiers for linkage to census data, resources for the linkage, and the availability of data sources with individual SES measures. This study assessed a new method of measuring community socioeconomic status (SES) that can be used with the publicly available National Health Interview Survey (NHIS) and preserves confidentiality and can be used with individual SES measures from the NHIS. METHODS: The associations between community SES and mortality from all causes and breast cancer in women were assessed in two samples: 1) deaths in 1987-1993 NHIS respondents linked to community SES measures developed with the new method; and 2) deaths in 1991 from the National Multiple Cause of Death Files linked to 1990 county-level census SES measures. The magnitude of crude mortality rates, direction of trend, and age-adjusted relative risk of mortality for low vs. high SES were compared in the two samples. RESULTS: Crude all-cause mortality and breast cancer mortality rates were similar in both samples in terms of magnitude and direction of trend. In both samples, as SES decreased, rates of all-cause mortality increased, whereas breast cancer mortality rates tended to decrease. Age-adjusted relative risks of mortality from all causes and breast cancer for low vs. high SES were similar in the two samples. CONCLUSIONS: Similarity of associations between community SES and mortality from all causes and breast cancer in the two samples provides support for the validity of a new NHIS-based method of measuring community SES. Since the NHIS is a large, nationally representative survey with high response rates and low loss to mortality follow-up, this method represents an important resource for multi-level studies.
AB - PURPOSE: Increasingly researchers are interested in assessing the role of community socioeconomic status (SES) in poor health outcomes, above and beyond the influence of low individual SES. However, the feasibility of conducting these multi-level studies is often limited by restrictions on release of confidential identifiers for linkage to census data, resources for the linkage, and the availability of data sources with individual SES measures. This study assessed a new method of measuring community socioeconomic status (SES) that can be used with the publicly available National Health Interview Survey (NHIS) and preserves confidentiality and can be used with individual SES measures from the NHIS. METHODS: The associations between community SES and mortality from all causes and breast cancer in women were assessed in two samples: 1) deaths in 1987-1993 NHIS respondents linked to community SES measures developed with the new method; and 2) deaths in 1991 from the National Multiple Cause of Death Files linked to 1990 county-level census SES measures. The magnitude of crude mortality rates, direction of trend, and age-adjusted relative risk of mortality for low vs. high SES were compared in the two samples. RESULTS: Crude all-cause mortality and breast cancer mortality rates were similar in both samples in terms of magnitude and direction of trend. In both samples, as SES decreased, rates of all-cause mortality increased, whereas breast cancer mortality rates tended to decrease. Age-adjusted relative risks of mortality from all causes and breast cancer for low vs. high SES were similar in the two samples. CONCLUSIONS: Similarity of associations between community SES and mortality from all causes and breast cancer in the two samples provides support for the validity of a new NHIS-based method of measuring community SES. Since the NHIS is a large, nationally representative survey with high response rates and low loss to mortality follow-up, this method represents an important resource for multi-level studies.
KW - All-cause Mortality
KW - Breast Neoplasms
KW - Residence Characteristics
KW - Socioeconomic Factors
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U2 - 10.1016/S1047-2797(03)00057-7
DO - 10.1016/S1047-2797(03)00057-7
M3 - Article
C2 - 14599737
AN - SCOPUS:0242352333
VL - 13
SP - 721
EP - 726
JO - Annals of Epidemiology
JF - Annals of Epidemiology
SN - 1047-2797
IS - 10
ER -