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Essay: Is the wealth index a proxy for consumption expenditure? A systematic review
L D Howe, J R Hargreaves, S Gabrysch and S R A Huttly
Journal of Epidemiology and Community Health (1979-)
Vol. 63, No. 11 (November 2009), pp. 871-877
Published by: BMJ
Stable URL: http://www.jstor.org/stable/20721081
Page Count: 7
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Background: Many epidemiological studies require a measure of socioeconomic position. The monetary measure preferred by economists is consumption expenditure; the wealth index has been proposed as a reliable, simple alternative to expenditure and is extensively used. Methods: A systematic review was conducted of the agreement between wealth indices and consumption expenditure, summarising the agreement and exploring factors affecting agreement. Results: Seventeen studies using 36 datasets met the inclusion criteria. Of these, 22 demonstrated weak agreement, 10 moderate agreement, and four strong agreement. There was some evidence that agreement is higher: in middle-income settings; in urban areas; for wealth indices with a greater number of indicators; and for wealth indices including a wider range of indicators. Conclusions: The wealth index is mostly a poor proxy for consumption expenditure.
Journal of Epidemiology and Community Health (1979-) © 2009 BMJ