CAN WE MONITOR SOCIOECONOMIC INEQUALITIES IN HEALTH - A SURVEY OF US HEALTH DEPARTMENTS DATA-COLLECTION AND REPORTING PRACTICES

Objective. To evaluate the potential for and obstacles to routine moni toring of socioeconomic inequalities in health using U.S. vital statis tics and disease registry data, the authors surveyed current data coll ection and reporting practices for specific socioeconomic variables. M ethods. In 1996 the authors mailed a seif-administered survey to all o f the 55 health department vital statistics offices reporting data to the National Center for Health Statistics (NCHS) to determine what kin ds of socioeconomic data they collected on birth and death certificate s and in cancer, AIDS, and tuberculosis (TB) registries and what kinds of socioeconomic data were routinely reported in health department pu blications. Results. Health departments routinely obtained data on occ upation on death certificates and in most cancel-registries. They coll ected data on educational level for both birth and death certificates. None of the databases collected information on income, and few obtain ed data on employment status, health insurance carrier, or receipt of public assistance. When socioeconomic data were collected, they were u sually not included in published reports (except for mothers education al level in birth certificate data). Obstacles cited to collecting and reporting socioeconomic data included lack of resources and concerns about the confidentiality and accuracy of data. All databases, however , included residential addresses: suggesting records could be geocoded and linked to Census-based socioeconomic data. Conclusions. U.S. stat e and Federal vital statistics and disease registries should routinely collect and publish socioeconomic data to improve efforts to monitor trends in and reduce social inequalities in health.