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Is the wealth index a proxy for consumption expenditure? A systematic review
  1. Laura D Howe1,
  2. James R Hargreaves2,
  3. Sabine Gabrysch2,
  4. Sharon R A Huttly2
  1. 1 University of Bristol, United Kingdom;
  2. 2 London School of Hygiene & Tropical Medicine, United Kingdom
  1. E-mail: laura.howe{at}bristol.ac.uk

Abstract

Background: Many epidemiological studies require a measure of socio-economic 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: We conducted a systematic review of the agreement between wealth indices and consumption expenditure, summarising the agreement and exploring factors affecting agreement.

Results: 17 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.

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