Abstract
BackgroundAlmost all studies in health research control or investigate socioeconomic position (SEP) as exposure or confounder. Different measures of SEP capture different aspects of the underlying construct, so efficient methodologies to combine them are needed. SEP and ethnicity are strongly associated, however not all measures of SEP may be appropriate for all ethnic groups.MethodsWe used latent class analysis (LCA) to define subgroups of women with similar SEP profiles using 19 measures of SEP. Data from 11,326 women were used, from eight different ethnic groups but with the majority from White British (40%) or Pakistani (45%) backgrounds, who were recruited during pregnancy to the Born in Bradford birth cohort study.ResultsFive distinct SEP subclasses were identified in the LCA: (i) "Least socioeconomically deprived and most educated" (20%); (ii) "Employed and not materially deprived" (19%); (iii) "Employed and no access to money" (16%); (iv) "Benefits and not materially deprived" (29%) and (v) "Most economically deprived" (16%). Based on the magnitude of the point estimates, the strongest associations were that compared to White British women, Pakistani and Bangladeshi women were more likely to belong to groups: (iv) "benefits and not materially deprived" (relative risk ratio (95% CI): 5.24 (4.44, 6.19) and 3.44 (2.37, 5.00), respectively) or (v) most deprived group (2.36 (1.96, 2.84) and 3.35 (2.21, 5.06) respectively) compared to the least deprived class. White Other women were more than twice as likely to be in the (iv) "benefits and not materially deprived group" compared to White British women and all ethnic groups, other than the Mixed group, were less likely to be in the (iii) "employed and not materially deprived" group than White British women.ConclusionsLCA allows different aspects of an individual’s SEP to be considered in one multidimensional indicator, which can then be integrated in epidemiological analyses. Ethnicity is strongly associated with these identified subgroups. Findings from this study suggest a careful use of SEP measures in health research, especially when looking at different ethnic groups. Further replication of these findings is needed in other populations.
Highlights
Almost all studies in health research control or investigate socioeconomic position (SEP) as exposure or confounder
We assigned the following labels to the groups; (i) “Least socioeconomically deprived and most educated” (20% n = 2231), (ii) “Employed and not materially deprived” (19%, n = 2248), Association between ethnicity and Latent class analysis (LCA) subgroups In the multinomial models the “least socioeconomically deprived and most educated” group was used as the reference category (Table 5)
Women of Mixed, Pakistani and Bangladeshi ethnicities were more likely to be in the “benefits and not materially deprived group” compared to White British women (adjusted relative risk ratios (RRR) = 2.37, RRR = 5.24 and RRR = 3.44 respectively)
Summary
Almost all studies in health research control or investigate socioeconomic position (SEP) as exposure or confounder. While the definition clearly indicates the need to include multiple components in its assessment, single measures of SEP (such as occupation or educational attainment) are frequently used in research In part this may reflect the availability of only one or two measurements in a given study, but it may reflect lack of certainty about how to combine a number of different measurements appropriately, where there are complex patterns of missing data between measurements. Educational attainment might have markedly different meaning for people from different ethnic groups ( if education has been received in different countries) [4,5] These differences may be reflected in patterns of missing data, for example there may be gender and ethnic differences in ability or willingness to answer questions about total household income
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