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A two-county comparison of the HOUSES index on predicting self-rated health
  1. Michael C Butterfield1,
  2. Arthur R Williams2,
  3. Tim Beebe3,
  4. Dawn Finnie3,
  5. Heshan Liu3,
  6. Juliette Liesinger3,
  7. Jeff Sloan3,
  8. Philip H Wheeler4,
  9. Barbara Yawn5,
  10. Young J Juhn6
  1. 1UC Berkeley-UC San Francisco Joint Medical Program, Berkeley, California, USA
  2. 2Center for Health Outcomes and Health Services Research, Children's Mercy Hospitals and Clinics and Office of the Mayor, City of Kansas City, Missouri, USA
  3. 3Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
  4. 4Rochester-Olmsted County Planning Department, Minnesota, USA
  5. 5Olmsted Medical Center, Department of Research, Rochester, Minnesota, USA
  6. 6Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
  1. Correspondence to Young J Juhn, Division of Community Pediatric and Adolescent Medicine, Department of Pediatric and Adolescent Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; juhn.young{at}


Background Mortality, incidence of most diseases, and prevalence of adverse health behaviours follow an inverse gradient with social class. Many proxies for socioeconomic status (SES) exist; however, each bears a different relation to health outcomes, probably following a different aetiological pathway. Additionally, data on SES can be quite difficult to gather. Five measures of SES were compared, including a novel measure, the HOUSES index, in the prediction of self-rated health (SRH) in two Midwestern settings, Olmsted County, Minnesota, and Jackson County, Missouri.

Methods Using a probability sampling design, a cross-sectional telephone survey was administered to a randomised sample of households. The questionnaire collected a variety of sociodemographic and personal health information. The dependent variable, SRH, was dichotomised into excellent/very good/good versus fair/poor health. Information for the HOUSES index was collected through public property records and corroborated through the telephone questionnaire. Participants were parents/guardians of children aged 1–17 residing in Olmsted County (n=746) and Jackson County (n=704).

Results The HOUSES index was associated with adverse SRH in Jackson County adults. All five SES measures were significant predictors in this group. Composite SES indices showed significant associations with SRH in Olmsted County adults.

Conclusions The HOUSES index makes a unique contribution to the measurement of SES and prediction of health outcomes. Its utility is qualified by specific social contexts, and it should be used in concert with other SES indices.

  • Housing
  • housing and health, self-rated health
  • social class

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  • Funding NIH grant (R21 HD51902) from the National Institute of Child Health and Human Development.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Mayo Clinic Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.