The impact of different measures of socioeconomic position on the relationship between ethnicity and health

PURPOSE: In this study we explicitly examine the effect of using asset-based and conventional measures of socioeconomic position (SEP) on ethnic differences in health. METHODS: The survey of white (n = 227), Indian and Pakistani (n = 233), and African Caribbean (n = 213) adults aged 18 to 59 years living in Leeds, United Kingdom aimed to examine the relationship between ethnicity, health, and SEP. SEP variables included perceived ability to get 10,000 pound if needed, car ownership, level of education, and home ownership. Health variables included self-reported health status, presence of a long-term illness or disability, presence of limitations arising from a long-term illness or disability, one or more limitations in mobility, obesity, and being anxious, worried, or depressed. Logistic regression analysis was used to assess the relationship between ethnicity and SEP and health. Five models were run for each health variable so that the effects of changing the SEP measure could be ascertained. The first model included only ethnicity and the remaining 4 models tested the effects of the perceived ability to get 10,000 pound, car ownership, level of education, and home ownership separately. RESULTS: The results suggest that the statistical inclusion of asset-based SEP measures, such as car ownership and ability to obtain 10,000 pound, which reflect an individual's ability to mobilize resources, tend to increase ethnic differences in health, whereas more conventional steady-state indicators, such as education level and home ownership, tended to have little effect or to reduce ethnic differences in health. CONCLUSIONS: Overall, this study suggests that the choice of SEP measure may affect the conclusion of research on ethnicity and health and that choice of SEP measures should in turn be informed by the research problem being examined.