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Measuring older people's socioeconomic position: a scoping review of studies of self-rated health, health service and social care use

Lookup NU author(s): Dr Gemma Frances SpiersORCiD, Dr Jenny Liddle, Dr Daniel StowORCiD, Dr Ben Searle, Dr Orla Whitehead, Dr Andrew Kingston, Emerita Professor Suzanne Moffatt, Professor Fiona MatthewsORCiD, Professor Barbara Hanratty

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ. BACKGROUND: The challenges of measuring socioeconomic position in older populations were first set out two decades ago. However, the question of how best to measure older people's socioeconomic position remains pertinent as populations age and health inequalities widen. METHODS: A scoping review aimed to identify and appraise measures of socioeconomic position used in studies of health inequalities in older populations in high-income countries. Medline, Scopus, EMBASE, HMIC and references lists of systematic reviews were searched for observational studies of socioeconomic health inequalities in adults aged 60 years and over, published between 2000 and 2020. A narrative synthesis was conducted. FINDINGS: One-hundred and thirty-eight studies were included; 20 approaches to measuring socioeconomic position were identified. Few studies considered which pathways the chosen measures of socioeconomic position intended to capture. The validity of subjective socioeconomic position measures, and measures that assume shared income and educational capital, should be verified in older populations. Incomplete financial data risk under-representation of some older groups when missing data are socially patterned. Older study samples were largely homogeneous on measures of housing tenure, and to a lesser extent, measures of educational attainment. Measures that use only two response categories risk missing subtle differences in older people's socioeconomic circumstances. CONCLUSION: Poor choice of measures of socioeconomic position risk underestimating the size of health inequalities in older populations. Choice of measures should be shaped by considerations of theory, context and response categories that detect subtle, yet important, inequalities. Further evidence is required to ascertain the validity of some measures identified in this review.


Publication metadata

Author(s): Spiers GF, Liddle JE, Stow D, Searle B, Whitehead IO, Kingston A, Moffatt S, Matthews FE, Hanratty B

Publication type: Article

Publication status: Published

Journal: Journal of Epidemiology and Community Health

Year: 2022

Volume: 76

Issue: 6

Pages: 572-579

Print publication date: 01/06/2022

Online publication date: 15/03/2022

Acceptance date: 17/02/2022

Date deposited: 30/05/2022

ISSN (print): 0143-005X

ISSN (electronic): 1470-2738

Publisher: BMJ Publishing Group Ltd

URL: https://doi.org/10.1136/jech-2021-218265

DOI: 10.1136/jech-2021-218265

PubMed id: 35292509


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Funding

Funder referenceFunder name
NHS North England Commissioning Support
NIHR SPCR

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