Using latent class analysis to develop a model of the relationship between socioeconomic position and ethnicity: cross-sectional analyses from a multi-ethnic birth cohort study

Abstract

Background: Almost all studies in health research control or investigate socioeconomic position (SEP) as exposure or confounder. Different measures of SEP capture different aspects of the underlying construct, so efficient methodologies to combine them are needed. SEP and ethnicity are strongly associated, however not all measures of SEP may be appropriate for all ethnic groups.

Methods: We used latent class analysis (LCA) to define subgroups of women with similar SEP profiles using 19 measures of SEP. Data from 11,326 women were used, from eight different ethnic groups but with the majority from White British (40%) or Pakistani (45%) backgrounds, who were recruited during pregnancy to the Born in Bradford birth cohort study.

Results: Five distinct SEP subclasses were identified in the LCA: (i) "Least socioeconomically deprived and most educated" (20%); (ii) "Employed and not materially deprived" (19%); (iii) "Employed and no access to money" (16%); (iv) "Benefits and not materially deprived" (29%) and (v) "Most economically deprived" (16%). Based on the magnitude of the point estimates, the strongest associations were that compared to White British women, Pakistani and Bangladeshi women were more likely to belong to groups: (iv) "benefits and not materially deprived" (relative risk ratio (95% CI): 5.24 (4.44, 6.19) and 3.44 (2.37, 5.00), respectively) or (v) most deprived group (2.36 (1.96, 2.84) and 3.35 (2.21, 5.06) respectively) compared to the least deprived class. White Other women were more than twice as likely to be in the (iv) "benefits and not materially deprived group" compared to White British women and all ethnic groups, other than the Mixed group, were less likely to be in the (iii) "employed and not materially deprived" group than White British women.

Conclusions: LCA allows different aspects of an individual's SEP to be considered in one multidimensional indicator, which can then be integrated in epidemiological analyses. Ethnicity is strongly associated with these identified subgroups. Findings from this study suggest a careful use of SEP measures in health research, especially when looking at different ethnic groups. Further replication of these findings is needed in other populations.

Figure 1

Summary of selected predicted probabilities for levels of SEP indicators from 5 class model for all women. Class 1: "Least socioeconomically deprived and most educated" (20%, n = 2231 (based on most likely class membership)). Class 2: "Employed, not materially deprived" (19%, n = 2248). Class 3: "Employed, no access to money" (16%, n = 1722). Class 4: "Benefits not materially deprived" (29%, n = 3325). Class 5: "Most economically deprived" (16%, n = 1800).

Figure 2

Summary of selected predicted probabilities for levels of SEP indicators from 4 class model for White British women. Class1: "Employed, educated and not materially deprived" (44%, n = 2038 (based on most likely class membership)). Class 2: "Employed, moderate education, materially deprived" (14%, n = 614). Class 3: "Low education, benefits not materially deprived" (23%, n = 992). Class 4: "Low education, benefits, subjectively poor and materially deprived" (18%, n = 836).

Figure 3

Summary of selected predicted probabilities for levels of SEP indicators from 4 class model for Pakistani women. Class1: "Educated, low benefits, not materially deprived" (22%, n = 1113 (based on most likely class membership)). Class 2: "Women employed, moderate education, benefits, not materially deprived" (17%, N = 935). Class 3: "Women not employed, low education, benefits, not materially deprived" (33%, n = 1642). Class 4: "Women not employed, moderate education, benefits, subjectively poor and materially deprived" (28%, n = 1427).