BACKGROUND: Census-based measures of income often are used as proxies for individual-level income. Yet, the validity of such area-based measures relative to 'true' individual-level income has not been fully characterized. OBJECTIVES: The objectives of this study were (1) to determine whether area-based measures of household income are a suitable proxy for self-reported household income and (2) to assess whether these measures are associated with outcomes in a cardiac disease cohort. RESEARCH DESIGN: We used a prospective cohort from the Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH) cardiac catheterization registry. SUBJECTS: A total of 4372 patients having undergone cardiac catheterization and who also completed a 1-year follow-up questionnaire on self-reported income level were studied. MEASURES: Our measurements were survival to 2.5 years after catheterization and health-related quality of life (EuroQoL). RESULTS: Agreement between the 2 income measures generally was poor (unweighted Kappa = 0.07), particularly for the low-income patients. Despite this poor agreement, both income measures were positively associated with survival and EuroQoL scores. An outcome analysis that simultaneously considered individual level income and area-based income revealed that low-income individuals have poorer survival and lower quality of life scores if they live in low income neighborhoods, but not if they live in high income neighborhoods. CONCLUSIONS: The area-based estimates of household income in these data demonstrate poor agreement with self-reported household income at the level of individual patients, particularly for low-income patients. Despite this, both income measures appear to be prognostically relevant, perhaps because individual and neighborhood income measure different constructs.
BACKGROUND: Census-based measures of income often are used as proxies for individual-level income. Yet, the validity of such area-based measures relative to 'true' individual-level income has not been fully characterized. OBJECTIVES: The objectives of this study were (1) to determine whether area-based measures of household income are a suitable proxy for self-reported household income and (2) to assess whether these measures are associated with outcomes in a cardiac disease cohort. RESEARCH DESIGN: We used a prospective cohort from the Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH) cardiac catheterization registry. SUBJECTS: A total of 4372 patients having undergone cardiac catheterization and who also completed a 1-year follow-up questionnaire on self-reported income level were studied. MEASURES: Our measurements were survival to 2.5 years after catheterization and health-related quality of life (EuroQoL). RESULTS: Agreement between the 2 income measures generally was poor (unweighted Kappa = 0.07), particularly for the low-income patients. Despite this poor agreement, both income measures were positively associated with survival and EuroQoL scores. An outcome analysis that simultaneously considered individual level income and area-based income revealed that low-income individuals have poorer survival and lower quality of life scores if they live in low income neighborhoods, but not if they live in high income neighborhoods. CONCLUSIONS: The area-based estimates of household income in these data demonstrate poor agreement with self-reported household income at the level of individual patients, particularly for low-income patients. Despite this, both income measures appear to be prognostically relevant, perhaps because individual and neighborhood income measure different constructs.
Authors: Moira K Kapral; Jiming Fang; Crystal Chan; David A Alter; Susan E Bronskill; Michael D Hill; Douglas G Manuel; Jack V Tu; Geoffrey M Anderson Journal: Neurology Date: 2012-08-15 Impact factor: 9.910
Authors: Matthew E Dupre; Alicia Nelson; Scott M Lynch; Bradi B Granger; Hanzhang Xu; Erik Churchill; Janese M Willis; Lesley H Curtis; Eric D Peterson Journal: Am J Med Sci Date: 2017-07-25 Impact factor: 2.378
Authors: András Folyovich; Ildikó Vastagh; Anna Kéri; Angéla Majoros; Koppány Levente Kovács; András Ajtay; Zsuzsanna Laki; Bence Gunda; Katalin Erdei; Laura Lenti; Zsófia Dános; Dániel Bereczki Journal: Int J Public Health Date: 2015-04-08 Impact factor: 3.380
Authors: Timothy S Chang; Ronald E Gangnon; C David Page; William R Buckingham; Aman Tandias; Kelly J Cowan; Carrie D Tomasallo; Brian G Arndt; Lawrence P Hanrahan; Theresa W Guilbert Journal: J Biomed Inform Date: 2014-12-20 Impact factor: 6.317
Authors: Maria R Pardo-Crespo; Nirmala Priya Narla; Arthur R Williams; Timothy J Beebe; Jeff Sloan; Barbara P Yawn; Philip H Wheeler; Young J Juhn Journal: J Epidemiol Community Health Date: 2013-01-15 Impact factor: 3.710
Authors: Susan M Samuel; Luz Palacios-Derflingher; Marcello Tonelli; Braden Manns; Lynden Crowshoe; Sofia B Ahmed; Min Jun; Nathalie Saad; Brenda R Hemmelgarn Journal: CMAJ Date: 2013-12-02 Impact factor: 8.262
Authors: Gabriel E Fabreau; Alexander A Leung; Danielle A Southern; Merrill L Knudtson; J Michael McWilliams; John Z Ayanian; William A Ghali Journal: Circ Cardiovasc Qual Outcomes Date: 2014-06-03