Social class, position, or socioeconomic status (SES) is an important construct in social and clinical epidemiology. Research has demonstrated that measures of SES are strongly associated with health outcomes and access to health care services. SES also is an important covariate that must be """"""""controlled"""""""" when the effects of interventions are studied. Despite the recognized importance of measures of SES, socioeconomic data are often unavailable in data sets used for health services research, such as medical records, disease registries, and vital statistics. Medical records or administrative data, however, do routinely contain addresses of patients. Address information might allow researchers to link patient data to housing characteristics enumerated within real property tax assessment records. If such a linkage can be done, researchers might be able to construct a housing-based measure of SES for all or most patients. New opportunities for investigators to use previously collected administrative data sets, medical records, or disease registries for basic and applied research also would be opened. The major goal of the proposed study is to explore a unique methodological avenue for producing a measure of housing-based socioeconomic status (HSES) that is derived from individual housing data and that would overcome the absence of socioeconomic data in frequently used data sources. Our 4 specific study aims are:
Specific Aim 1 : To develop a socioeconomic indicator for individuals derived from a composite of characteristics (tenure, type, and size, etc.) of individual housing data (i.e., HSES), and, to determine whether this composite indicator (i.e., HSES) is improved when """"""""neighborhood"""""""" socioeconomic status (NSES) is incorporated into the indicator.
Aim 1 is the primary aim of the study.
Specific Aim 2 : To determine the criterion validity of the HSES by comparing the classification of persons on the HSES with socioeconomic classifications of these persons on the Hollingshead 4-Factor Index of Social Status and Nakao-Treas Occupational Prestige Scores, 2 widely used measures of social position.
Specific Aim 3 : To assess the construct validity of the HSES by evaluating statistical associations between the HSES, asthma prevalence, and general health status of parents and children (1-18 years).
Specific Aim 4 : To determine the external validity of the HSES constructed with Olmsted County, Minnesota, data by refitting the index on a sample of children and parents in Jackson County, Missouri. The latter is a more ethnically and racially diverse environment than Olmsted County. We have checked the data elements in the Jackson County files against those in Olmsted County, and the 2 are compatible on all elements to be used in this study. To accomplish the proposed study aims, we will perform a dual-site cross-sectional study that develops and validates the socioeconomic indicators derived from housing characteristics (i.e., HSES) and neighborhood socioeconomic status (NSES) for parents of children in Olmsted County, Minnesota, and Jackson County, Missouri. Telephone interviews will be completed with 1,400 parents of children 1-18 years to obtain additional data. ? ?
