Measuring socio-economic position for epidemiological studies in low- and middle-income countries: a methods of measurement in epidemiology paper

Much has been written about the measurement of socio-economic
position (SEP) in high-income countries (HIC). Less has been written
for an epidemiology, health systems and public health audience
about the measurement of SEP in low- and middle-income countries
(LMIC). The social stratification processes in many LMIC—and
therefore the appropriate measurement tools—differ considerably
from those in HIC. Many measures of SEP have been utilized in
epidemiological studies; the aspects of SEP captured by these measures
and the pathways through which they may affect health are
likely to be slightly different but overlapping. No single measure of
SEP will be ideal for all studies and contexts; the strengths and
limitations of a given indicator are likely to vary according to the
specific research question. Understanding the general properties of
different indicators, however, is essential for all those involved in
the design or interpretation of epidemiological studies. In this article,
we describe the measures of SEP used in LMIC. We concentrate
on measures of individual or household-level SEP rather than
area-based or ecological measures such as gross domestic product.
We describe each indicator in terms of its theoretical basis, interpretation,
measurement, strengths and limitations. We also provide
brief comparisons between LMIC and HIC for each measure.