Race/ethnicity, gender, and monitoring socioeconomic gradients in health: a comparison of area-based socioeconomic measures--the public health disparities geocoding project

Abstract

Use of multilevel frameworks and area-based socioeconomic measures (ABSMs) for public health monitoring can potentially overcome the absence of socioeconomic data in most US public health surveillance systems. To assess whether ABSMs can meaningfully be used for diverse race/ethnicity-gender groups, we geocoded and linked public health surveillance data from Massachusetts and Rhode Island to 1990 block group, tract, and zip code ABSMs. Outcomes comprised death, birth, cancer incidence, tuberculosis, sexually transmitted infections, childhood lead poisoning, and nonfatal weapons-related injuries. Among White, Black, and Hispanic women and men, measures of economic deprivation (e.g., percentage below poverty) were most sensitive to expected socioeconomic gradients in health, with the most consistent results and maximal geocoding linkage evident for tract-level analyses.

FIGURE 1—

Scaled relative index of inequality (RII) plot, with ln (RII/median RII) for the 11 area-based socioeconomic measures (ABSMs) at the census tract level (Massachusetts, ca. 1990) for all health outcomes for (a) total population, (b) White women, (c) Black women, (d) Hispanic women, (e) White men, (f) Black men, (g) Hispanic men, and (h) for low birthweight and premature mortality only for Asian and Pacific Islander and American Indian women and men, from The Public Health Disparities Geocoding Project. Note. MA = Massachusetts; RI = Rhode Island; WRISS = Weapons-Related Injury Surveillance System. For explanation of SEP1 and SEP index, see “Methods” section.

FIGURE 1—

Scaled relative index of inequality (RII) plot, with ln (RII/median RII) for the 11 area-based socioeconomic measures (ABSMs) at the census tract level (Massachusetts, ca. 1990) for all health outcomes for (a) total population, (b) White women, (c) Black women, (d) Hispanic women, (e) White men, (f) Black men, (g) Hispanic men, and (h) for low birthweight and premature mortality only for Asian and Pacific Islander and American Indian women and men, from The Public Health Disparities Geocoding Project. Note. MA = Massachusetts; RI = Rhode Island; WRISS = Weapons-Related Injury Surveillance System. For explanation of SEP1 and SEP index, see “Methods” section.

FIGURE 1—

Scaled relative index of inequality (RII) plot, with ln (RII/median RII) for the 11 area-based socioeconomic measures (ABSMs) at the census tract level (Massachusetts, ca. 1990) for all health outcomes for (a) total population, (b) White women, (c) Black women, (d) Hispanic women, (e) White men, (f) Black men, (g) Hispanic men, and (h) for low birthweight and premature mortality only for Asian and Pacific Islander and American Indian women and men, from The Public Health Disparities Geocoding Project. Note. MA = Massachusetts; RI = Rhode Island; WRISS = Weapons-Related Injury Surveillance System. For explanation of SEP1 and SEP index, see “Methods” section.

FIGURE 1—

Scaled relative index of inequality (RII) plot, with ln (RII/median RII) for the 11 area-based socioeconomic measures (ABSMs) at the census tract level (Massachusetts, ca. 1990) for all health outcomes for (a) total population, (b) White women, (c) Black women, (d) Hispanic women, (e) White men, (f) Black men, (g) Hispanic men, and (h) for low birthweight and premature mortality only for Asian and Pacific Islander and American Indian women and men, from The Public Health Disparities Geocoding Project. Note. MA = Massachusetts; RI = Rhode Island; WRISS = Weapons-Related Injury Surveillance System. For explanation of SEP1 and SEP index, see “Methods” section.