Lecture 13: Measuring The Socio-economic Determinants Of Health

Question 1

What is socio-economic position?

Answer 1

The social and economic factors the influence what positions individuals or groups hold within the structure of a society

Question 2

What are the three key characteristics of determinants?

Answer 2

Objective
Measurable
Meaningful

Question 3

Other names for socio-economic position?

Answer 3

Socio-economic status, social class, social stratification, socio-economic background

Question 4

Why measure socio-economic position?

Answer 4

• to quantify the level of inequality within or between societies
• may highlight changes to population structures over time (census periods or generations)
  -help understand relationship between health and social variables e.g age
  Have been associated with health and life chances

Question 5

Two types of incomes to measure in surveys?

Answer 5

Personal income (can be sensitive) and household income (family size needed, useful indicator for women)

Question 6

Two ways to measure income?

Answer 6

Absolute measures and categorical measures

Question 7

Why is measure of income important?

Answer 7

• most direct measure of material resources
• have a dose-response association with health
• have a cumulative effect over life course
• have the greatest potential to change over a short duration

Question 8

Define measuring education

Answer 8

Measuring knowledge related assets of an individual

Question 9

Two types of education measurement?

Answer 9

• Continuous variable (e.g years of education)

- Categorical variable (education attainments)

Question 10

Pros of measuring education?

Answer 10

• shows transition of SEP from parent to personal
• believed to have association with ability to respond to health promotion message
• easy to obtain (good response rate)

Question 11

Cons of measuring education?

Answer 11

Cohort effect

Different standards of education in different countries

Question 12

How is occupation measured?

Answer 12

The NZSEI groups jobs by potential income
Can be measured as: current or longest held position, or parental occupation
Occupation is transferable- head of household

Question 13

Importance of occupation?

Answer 13

Close association with income
Reflects social standing
Individuals experience occupational or social motility over life course

Question 14

What does occupation influence?

Answer 14

Social network
Work-related stress
Occupational exposure to environmental risks

Question 15

What is NEET?

Answer 15

“Not in education, employment or training”
An indicator of SEP, considers ideal pathways for school leavers
Not used to describe identity of individuals or groups, but their situation or official status
Relates Le k of education to increased mortality rate

Question 16

Define social gradient

Answer 16

The fact that inequalities in population health status are related to inequalities in social status

Question 17

Odds ratio equation?

Answer 17

(A/c)/(b/d)

Question 18

What is the Preston curve representative of?

Answer 18

The cross sectional relationship between life expectancy and real per capita income
(Increase income means increased life expectancy)

Question 19

Which SEP measure is transferable?

Answer 19

Occupation (eg “head of household” for spouse and dependants)

Question 20

Which SEP measure has s cumulative affect over the lifetime and has greatest potential to change over a short duration?

Answer 20

Income

Question 21

What measure can show trends in SEP between parents to personal?

Answer 21

Education

Question 22

Does the mothers education affect infant mortality rates?

Answer 22

Yes

Question 23

Who is the NZSEI by?

Answer 23

Statistics NZ

Question 24

How many NZSEI categories are there?

Answer 24

6

Question 25

What are the three health variables asked in the NZSEI?

Answer 25

Health status (self assessed poor health)
Behavioural indicator (cigarette smoking)
Health service utilisation (GP visits in the last year)

Question 26

What are the 6 classes in the NZSEI?

Answer 26

1. Legislators and administrators
2. Professionals (eg teaching, health sciences, engineers)
3. Managers, armed forces, associate professionals
4. Trade workers, clerks
5. Service workers, sales people,
6. Agricultural and fishery workers

Question 27

What is class 1 of NZSEI?

Answer 27

Administrators and legislators

Question 28

What’s class 6 of NZSEI?

Answer 28

Agricultural and fisheries workers

Question 29

Do you need to be working to be included in NZSEI?

Answer 29

Yes

Question 30

Is there a smoking social gradient in NZSEI?

Answer 30

Yes