Inequalities in health: definitions, concepts, and theories

Figures & data

Table 1 Indicators of socioeconomic position used in health research measured at the individual level

Education	Usually used as categorical measuring the levels achieved; also as a continuous variable measuring the total number of years of education
Income	Indicator that, jointly with wealth, directly measures the material resources component of SEP. Usually measured as household gross income per number of persons dependable on this income
Wealth	Includes income and all accumulated material resources
Occupation-based indicators
The Registrar General's Social Classes^a	Groupings of occupation based on prestige in six hierarchical groups: I (highest), II, III non-manual, III-manual, IV, V (lowest). Often regrouped as manual versus non-manual
Erikson and Goldthorpe Class Schema	Groupings of occupations based on specific characteristics of employment relations such as type of contractual agreement, independence of work, authority delegation, etc. Not a hierarchical classification
UK National Statistics Socio-Economic Classification^b	Based on the same principles as the Erikson and Goldthorpe scheme. Creates non-hierarchical groups
Wright's Social Class Scheme	Based on Marxist principle of relation to the means of production. Not a hierarchical classification
Cambridge Social Interaction and Stratification scale	Based on patterns of social interaction in relation to occupational groups
Occupational-based census classification	For example, US census classification, country-specific socioeconomic classifications
Other indicators
Unemployment	Lack of employment
Housing	Housing tenure, household amenities, housing characteristics, broken window index, social standing of the habitat
Overcrowding	Calculated as the number of persons living in the household per number of rooms available in the house (usually excluding kitchen and bathrooms)
Composite indicators	At individual (usually measured as a score that adds up the presence or absence of several SEP indicators) or at area level
Proxy indicators	These are not strictly indicators of SEP but they can be strongly correlated with SEP and when more appropriate information is not available they may be useful in describing social patterning. Some cases may provide insight into the mechanism that explains the underlying association of SEP and a particular health outcome. However, they may be associated with the health outcome through independent mechanisms not related to their correlation with SEP

^aAlso known as British Occupational-based Social Class.

^bCurrent official indicator of SEP in the UK, also known as NS-SEC scheme.

Source: Taken directly from Galobardes et al. (34).

Fig. 1 The impact of socioeconomic status on health across the life course. Source: Taken directly from Adler et al. (57).

Galobardes B, Lynch J, Smith GD. Measuring socioeconomic position in health research. Br Med Bull. 2007; 81–82: 21–37.

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Adler NE, Stewart J, Cohen S, Cullen M, Roux AD, Dow W. Reaching for a healthier life: facts on socioeconomic status and health in the US. 2007; MacArthur Foundation Research Network on Socioeconomic Status and Health. 43.

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