Abstract
BackgroundSocioeconomic status (SES) is known to influence children’s health-related quality of life. Many SES indicators assess distinct dimensions of a family’s position rather than measuring the same underlying construct. Many researchers, however, see SES indicators as interchangeable. The primary aim of this study was to determine which measure of SES had the strongest impact on health-related quality of life.MethodsThis is a secondary analysis of the Pediatric Cardiac Quality of Life Inventory Validation Study. The SES variables were family income, Hollingshead Index (occupational prestige), and highest parent educational attainment level. Health-related quality of life was measured using the Pediatric Cardiac Quality of Life Inventory. Correlations tested the relationship among the three SES indicators. Regression-based modeling was used to calculate the strength of the association between SES measures and the Pediatric Cardiac Quality of Life Inventory.ResultsThe correlations among the SES measures were moderately high, with the correlation between the Hollingshead Index and parental education being r = 0.62 (95% CI = 0.56-0.65). There were equally high correlations between family income and the Hollingshead (r = 0.61, 95% CI = 0.57-0.65) and a slightly lower correlation between family income and parental education (r = 0.55, 95% CI = 0.52-0.59). Family income had the highest explanatory value compared to the Hollingshead Index or parental educational attainment, while controlling for sex, race, current cardiac status, and original diagnosis, accounting for 4-5% of the variation in patient and parent Pediatric Cardiac Quality of Life Inventory Total score, respectively, compared to the other SES measures.ConclusionFamily income as an SES measure demonstrated the greatest fidelity with respect to health-related quality of life as measured by the Pediatric Cardiac Quality of Life Inventory across respondent groups and explained more of the variation compared to the Hollingshead Index or highest parental educational attainment.
Highlights
Income, occupational prestige, and educational attainment are measures of Socio-Economic Status (SES) that have been found to influence an individual’s life opportunities
The primary aim of this study was to determine which measure of Socioeconomic status (SES) [family income, Hollingshead Index, and highest parent educational attainment level] had the strongest impact on Health Related Quality of Life (HRQOL) score using the Pediatric Cardiac Quality of Life Inventory (PCQLI), a disease-specific HRQOL instrument for children and adolescents with congenital or acquired heart disease, after adjusting for patient gender, race, and current cardiac status
7% of respondents did not answer the question about family income, which is much lower than what many social science researchers routinely anticipate on the income variable [22]
Summary
Occupational prestige, and educational attainment are measures of Socio-Economic Status (SES) that have been found to influence an individual’s life opportunities. Educational attainment reflects knowledge about health-related behaviors [12], contributes to an individual’s future earnings [15] and can provide “human capital” such as skills and aspirations necessary for the success of the family unit [13,14]. Another dimension often overlooked by health researchers is “social capital” that provide social networks connecting individuals to the larger community [13,14]. The primary aim of this study was to determine which measure of SES had the strongest impact on health-related quality of life
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