Assessing ecologic proxies for household income: a comparison of householdand neighbourhood level income measures in the study of population health status

This paper examines the validity of using ecologic measures of socioeconomi c status as proxies for individual-level measures in the study of populatio n health. Based on a representative 5% sample of households in a Canadian p rovince, the study integrated three sources of information: administrative records of individual health care utilization, records of deaths and 1986 c ensus records which contained information on household income and average n eighbourhood income. Thirteen measures of health status were developed from these sources of information. The hypothesis that risk estimates derived f rom ecologic income measures will be attenuated relative to estimates obtai ned from household income was not supported. These results provide evidence for the use of ecologic-level measures of income in studies which do not h ave access to individual-level income measures. (C) 1999 Elsevier Science L td. All rights reserved.