ArticlePopulation health metrics2021
Comparisons of individual- and area-level socioeconomic status as proxies for individual-level measures: evidence from the Mortality Disparities in American Communities study.
Article in Population health metrics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 103 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
103 citing papers in PubMed, 2 syntheses or guidelines pooled it, 163 citations in OpenAlex.
- Effects of socioeconomic status on enrollment in clinical trials for cancer: A systematic review.Cancer medicine · 2024Pooled it
- Mediators of socioeconomic inequalities in preterm birth: a systematic review.BMC public health · 2022Pooled it
- Removing Price Discounts From the Tobacco Retail Environment: Effects on College Students' Risk of Using Smokeless Tobacco, Little Cigars, and Electronic Nicotine Delivery Devices.Journal of studies on alcohol and drugs · 2026Trial
- Effect of Patient Characteristics on Uptake of Screening Using a Mailed Human Papillomavirus Self-sampling Kit: A Secondary Analysis of a Randomized Clinical Trial.JAMA network open · 2022Trial
- Beyond biological risk: socioeconomic vulnerability and adverse pediatric kidney transplant outcomes.Pediatric nephrology (Berlin, Germany) · 2026Article
- Differences in socio-demographic and environmental exposures at home vs. school in the ECHO cohort.Journal of exposure science & environmental epidemiology · 2026Article
- Socioeconomic Inequalities in the Mortality of Hodgkin and Non-Hodgkin Lymphoma: A Two-Decade Trend Analysis.Current oncology (Toronto, Ont.) · 2026Article
- Rurality and long-term outcomes after critical illness.Annals of the American Thoracic Society · 2026Article
- Article
- Comparisons between individual- and area-level measures of socioeconomic status among childhood cancer patients: A report from the Children's Oncology Group (COG).Cancer epidemiology · 2026Article
- Income Persistence and the Risk of Hepatocellular Carcinoma in Individuals with Type 2 Diabetes.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2026Article
- Physical activity and sleep patterns in children attending after-school programs in Arizona: a cross-sectional study.Journal of activity, sedentary and sleep behaviors · 2026Article
- Incorporating polygenic risk scores and social determinants of health across populations: Considerations and best practices in research.American journal of human genetics · 2026Review
- Comparing Neighborhood Indices of Socioeconomic Status, Segregation, and Healthcare Access for Predicting Late-Stage Breast Cancer.Journal of urban health : bulletin of the New York Academy of Medicine · 2026Article
- California mortality and the Healthy Places Index.American journal of epidemiology · 2026Article
- The association between individual and neighbourhood-level measures of socioeconomic disadvantage and severe maternal morbidity, in the Netherlands, a retrospective cohort study.European journal of public health · 2026Article
- Impact of socioeconomic deprivation on risk and disease activity of Sjögren's disease.RMD open · 2026Article
- Accessibility and responsiveness of Better Access treatment services: Insights from the use of linked administrative data in the evaluation of Better Access.The Australian and New Zealand journal of psychiatry · 2026Article
- Disparities in emergency department outcomes by race during the 2022-2023 COVID-influenza twindemic.BMC emergency medicine · 2026Observational
- Clinical outcomes of lutetium-177-PSMA-617 in a racially diverse cohort of patients with metastatic castration-resistant prostate cancer.The oncologist · 2026Article
43 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundArea-level measures are often used to approximate socioeconomic status (SES) when individual-level data are not available. However, no national studies have examined the validity of these measures in approximating individual-level SES.
methodsData came from ~ 3,471,000 participants in the Mortality Disparities in American Communities study, which links data from 2008 American Community Survey to National Death Index (through 2015). We calculated correlations, specificity, sensitivity, and odds ratios to summarize the concordance between individual-, census tract-, and county-level SES indicators (e.g., household income, college degree, unemployment). We estimated the association between each SES measure and mortality to illustrate the implications of misclassification for estimates of the SES-mortality association.
resultsParticipants with high individual-level SES were more likely than other participants to live in high-SES areas. For example, individuals with high household incomes were more likely to live in census tracts (r = 0.232; odds ratio [OR] = 2.284) or counties (r = 0.157; OR = 1.325) whose median household income was above the US median. Across indicators, mortality was higher among low-SES groups (all p < .0001). Compared to county-level, census tract-level measures more closely approximated individual-level associations with mortality.
conclusionsModerate agreement emerged among binary indicators of SES across individual, census tract, and county levels, with increased precision for census tract compared to county measures when approximating individual-level values. When area level measures were used as proxies for individual SES, the SES-mortality associations were systematically underestimated. Studies using area-level SES proxies should use caution when selecting, analyzing, and interpreting associations with health outcomes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.