| Literature DB >> 26396585 |
John Townend1, Cosetta Minelli1, Imed Harrabi2, Daniel O Obaseki3, Karima El-Rhazi4, Jaymini Patel1, Peter Burney1.
Abstract
BACKGROUND: The importance of studying associations between socio-economic position and health has often been highlighted. Previous studies have linked the prevalence and severity of lung disease with national wealth and with socio-economic position within some countries but there has been no systematic evaluation of the association between lung function and poverty at the individual level on a global scale. The BOLD study has collected data on lung function for individuals in a wide range of countries, however a barrier to relating this to personal socio-economic position is the need for a suitable measure to compare individuals within and between countries. In this paper we test a method for assessing socio-economic position based on the scalability of a set of durable assets (Mokken scaling), and compare its usefulness across countries of varying gross national income per capita.Entities:
Keywords: Developing countries; Measurement tool development; Poverty; Respiratory diseases; Socio-economic position
Year: 2015 PMID: 26396585 PMCID: PMC4578326 DOI: 10.1186/s12982-015-0035-6
Source DB: PubMed Journal: Emerg Themes Epidemiol ISSN: 1742-7622
Characteristics of the samples and GNI per capita for the countries included in the study
| Annaba (Algeria) | Fes (Morocco) | Ife (Nigeria) | Penang (Malaysia) | Riyadh (Saudi Arabia) | Sousse (Tunisia) | Srinagar (India) | Tirana (Albania) | Total | |
|---|---|---|---|---|---|---|---|---|---|
| Included in random selection (number) | 969 | 985 | 1704 | 1217 | 936 | 799 | 1100 | 1200 | 8910 |
| Included in this study (number) | 886 | 955 | 1083 | 693 | 758 | 716 | 927 | 968 | 6986 |
| Sex | |||||||||
| Male | 442 (49.9 %) | 412 (43.1 %) | 406 (37.5 %) | 355 (51.2 %) | 411 (54.2 %) | 331 (46.2 %) | 499 (53.8 %) | 486 (50.2 %) | 3342 (47.8 %) |
| Female | 444 (50.1 %) | 543 (56.9 %) | 677 (62.5 %) | 338 (48.8 %) | 347 (45.8 %) | 385 (53.8 %) | 428 (46.2 %) | 482 (49.8 %) | 3644 (52.2 %) |
| Age | |||||||||
| 40–54 years | 538 (60.7 %) | 474 (49.6 %) | 522 (48.2 %) | 347 (50.1 %) | 544 (71.8 %) | 416 (58.1 %) | 603 (65.0 %) | 503 (52.0 %) | 3947 (56.5 %) |
| 55–69 years | 295 (33.3 %) | 363 (38.0 %) | 369 (34.1 %) | 305 (44.0 %) | 206 (27.2 %) | 254 (35.5 %) | 248 (26.8 %) | 351 (36.3 %) | 2391 (34.2 %) |
| ≥70 years | 53 (6.0 %) | 118 (12.4 %) | 192 (17.7 %) | 41 (5.9 %) | 8 (1.1 %) | 46 (6.4 %) | 76 (8.2 %) | 114 (11.8 %) | 648 (9.3 %) |
| GNI per capita ($US) | 12,860 | 6160 | 4930 | 22,530 | 53,760 | 9680 | 4750 | 9950 | |
Assets selected for the Mokken scale and Loevinger’s H coefficients, ranked by prevalence of ownership
| Asset | Hj coeff | N | % | Rank |
|---|---|---|---|---|
| Electricity | 0.68 | 6907 | 98.9 | 1 |
| Television | 0.73 | 6678 | 95.6 | 2 |
| Cell phone | 0.44 | 6627 | 94.9 | 3 |
| Refrigerator | 0.70 | 5619 | 80.4 | 4 |
| Indoor bath | 0.71 | 5616 | 80.4 | 5 |
| Indoor tap | 0.69 | 5478 | 78.4 | 6 |
| Flush toilet | 0.72 | 4682 | 67.0 | 7 |
| Washing machine | 0.76 | 4466 | 63.9 | 8 |
| Car | 0.61 | 3128 | 44.8 | 9 |
| Fixed phone | 0.74 | 3109 | 44.5 | 10 |
| Overall (H) | 0.70 |
The number (N) and percentage of respondents who owned each of the assets are shown. Overall number of respondents = 6986
Fig. 1Item response curves for each of the assets included in the Mokken scale
Fig. 2Assets ranked by percentage ownership within each country and overall. Higher ranks signify less commonly owned assets. For overall ownership the items were ranked in the order (1 most common) electricity, 2 television, 3 cell phone, 4 refrigerator, 5 indoor bath or shower, 6 indoor tap, 7 flush toilet, 8 washing machine, 9 car, (10 least common) fixed phone
Fig. 3Mokken scale scores vs. GNI per capita for the country the respondent lived in. Some random noise has been added to the individual scores to prevent many points overlying each other
Spearman’s rank correlation coefficients (rs) for correlations between Mokken scale scores and the stated variables
| Annaba (Algeria) | Fes (Morocco) | Ife (Nigeria) | Penang (Malaysia) | Riyadh (Saudi Arabia) | Sousse (Tunisia) | Srinagar (India) | Tirana (Albania) | |
|---|---|---|---|---|---|---|---|---|
| Highest level of schoolinga | ||||||||
| Respondent | 0.251* | 0.388* | 0.411* | 0.176* | 0.114* | 0.301* | 0.246* | 0.524* |
| Father | 0.161* | 0.149* | 0.217* | 0.147* | 0.056 | 0.149* | 0.220* | 0.441* |
| Mother | 0.068* | 0.066* | 0.182* | 0.184* | –0.014 | 0.190* | – | 0.405* |
| Height | 0.023 | 0.038 | 0.139* | 0.123* | 0.073 | 0.050 | 0.212* | 0.197* |
| BMI | 0.120* | 0.141* | 0.247* | –0.043 | –0.062 | 0.091* | 0.153* | 0.001 |
| Frequency of going hungryb | –0.338* | –0.389* | –0.204* | –0.128* | –0.070 | –0.312* | –0.152* | –0.111* |
| Number of people per room in housec | –0.187* | –0.385* | –0.019 | –0.054 | –0.131* | –0.136* | –0.414* | –0.117* |
* Denotes a statistically significant correlation (p < 0.05)
aHighest level of schooling completed, categorised as 0 = none, 1 = primary, 2 = middle, 3 = high, 4 = college/technical, 5 = university. None of the mothers had been educated in Srinagar
bSelf reported frequency of someone in the household going hungry for lack of money, categorised as 0 = never, 1 = occasionally, 2 = certain times of year, 3 = most months, 4 = most weeks, 5 = most days
cNumber of people per room = number of people living in the house/number of rooms in the house [excluding kitchen and bathroom(s)]
Fig. 4Mokken scale scores for current asset ownership vs. scores for aged 5 years. Some random noise has been added to the data to prevent many points overlying each other. 1:1 line is also shown. Note—cell phone was excluded from the current assets to make the scores more directly comparable with the scores for age 5
Fig. 5Association between respondents’ current age and their Mokken scale score for age 5 years. The figure relates the number of Mokken scale assets the respondent reported owning in their household when they were 5 years old to their age at the time of the survey. The mean scores for all respondents in each 1 year age group are also shown
Fig. 6Cumulative distributions of scores for the current asset ownership data compared to the distributions when one item (cell phone) was omitted or and additional, random item was included
Effects of imputing missing data
| Error | 5 % imputed | 10 % imputed | 25 % imputed |
|---|---|---|---|
| N (%) | N (%) | N (%) | |
| −4 | 0 (0.0) | 0 (0.0) | 1 (0.0) |
| −3 | 0 (0.0) | 0 (0.0) | 17 (0.2) |
| −2 | 6 (0.1) | 27 (0.4) | 126 (1.8) |
| −1 | 225 (3.2) | 437 (6.3) | 893 (12.8) |
| 0 | 6423 (91.9) | 5920 (84.7) | 4691 (67.1) |
| 1 | 316 (4.5) | 560 (8.0) | 1042 (14.9) |
| 2 | 16 (0.2) | 36 (0.5) | 178 (2.5) |
| 3 | 0 (0.0) | 6 (0.1) | 32 (0.5) |
| 4 | 0 (0.0) | 0 (0.0) | 6 (0.1) |
| Total | 6986 (100.0) | 6986 (100.0) | 6986 (100.0) |
| Number of respondents with ≥1 imputed response | 2869 (41.1) | 4621 (66.1) | 6583 (94.2) |
| Number of respondents with error within ±1 | 6964 (99.7) | 6917 (99.0) | 6626 (94.8) |
Errors in Mokken scale scores after removing a percentage of the responses for each asset at random and then re-imputing the data
Error was defined as the difference between the score using imputed data and the score using the original, observed data. The number and percentage of respondents with different magnitudes and directions of error are shown