PT - JOURNAL ARTICLE AU - Pardo-Crespo, Maria R AU - Narla, Nirmala Priya AU - Williams, Arthur R AU - Beebe, Timothy J AU - Sloan, Jeff AU - Yawn, Barbara P AU - Wheeler, Philip H AU - Juhn, Young J TI - Comparison of individual-level versus area-level socioeconomic measures in assessing health outcomes of children in Olmsted County, Minnesota AID - 10.1136/jech-2012-201742 DP - 2013 Apr 01 TA - Journal of Epidemiology and Community Health PG - 305--310 VI - 67 IP - 4 4099 - http://jech.bmj.com/content/67/4/305.short 4100 - http://jech.bmj.com/content/67/4/305.full SO - J Epidemiol Community Health2013 Apr 01; 67 AB - Background Socioeconomic status (SES) is an important determinant of health, but SES measures are frequently unavailable in commonly used datasets. Area-level SES measures are used as proxy measures of individual SES when the individual measures are lacking. Little is known about the agreement between individual-level versus area-level SES measures in mixed urban–rural settings. Methods We identified SES agreement by comparing information from telephone self-reported SES levels and SES calculated from area-level SES measures. We assessed the impact of this agreement on reported associations between SES and rates of childhood obesity, low birth weight <2500 g and smoking within the household in a mixed urban–rural setting. Results 750 households were surveyed with a response rate of 62%: 51% male, 89% Caucasian; mean child age 9.5 years. Individual-level self-reported income was more strongly associated with all three childhood health outcomes compared to area-level SES. We found significant disagreement rates of 22–31%. The weighted Cohen's κ indices ranged from 0.15 to 0.22, suggesting poor agreement between individual-level and area-level measures. Conclusion In a mixed urban–rural setting comprised of both rural and urbanised areas, area-level SES proxy measures significantly disagree with individual SES measures, and have different patterns of association with health outcomes from individual-level SES measures. Area-level SES may be an unsuitable proxy for SES when individual rather than community characteristics are of primary concern.