Is the wealth index a proxy for consumption expenditure? A systematic review
- 1Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London UK
- 2Department of Social Medicine, University of Bristol, Bristol, UK
- Correspondence to Dr L D Howe, Department of Social Medicine, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK; laura.howe{at}bristol.ac.uk
- Accepted 15 April 2009
- Published Online First 29 April 2009
Abstract
Background: Many epidemiological studies require a measure of socioeconomic position. The monetary measure preferred by economists is consumption expenditure; the wealth index has been proposed as a reliable, simple alternative to expenditure and is extensively used.
Methods: A systematic review was conducted of the agreement between wealth indices and consumption expenditure, summarising the agreement and exploring factors affecting agreement.
Results: Seventeen studies using 36 datasets met the inclusion criteria. Of these, 22 demonstrated weak agreement, 10 moderate agreement, and four strong agreement. There was some evidence that agreement is higher: in middle-income settings; in urban areas; for wealth indices with a greater number of indicators; and for wealth indices including a wider range of indicators.
Conclusions: The wealth index is mostly a poor proxy for consumption expenditure.
Footnotes
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Appendix available online only at http://jech.bmj.com/content/vol63/issue11
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Funding LH was supported by an Economic & Social Research Council/Medical Research Council Interdisciplinary PhD Studentship; JH is supported by an Economic & Social Research Council/Medical Research Council Post-doctoral Fellowship.
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Competing interests None.
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Provenance and peer review Not commissioned; externally peer reviewed.
