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.
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Appendix available online only at http://jech.bmj.com/content/vol63/issue11
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.
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.