The Family Affluence Scale as a Measure of National Wealth: Validation of an Adolescent Self-Report Measure

One explanation for a lack of consistency in SES-health associations in youth is that parent-based income and occupation measures are inadequate. The Family Affluence Scale (FAS), a four-item measure of family wealth, has been developed in the WHO Health Behaviour in School-aged Children Study as an alternative measure. The aim of this paper is to examine the criterion and construct validity of the FAS as a measure of national absolute wealth in 35 countries. A general measure of national wealth, Gross Domestic Product (GDP) for the year 2001, corrected for Purchasing Power Parity, was used as a gold standard. For the composite FAS index, there was a similar strength in country rank order correlation (0.87) as with GDP, and a Kappa agreement coefficient of 0.57, indicating good criterion validity. FAS index associations with national health indicators were systematically higher than the values obtained with GDP. These features suggest that FAS can be used with confidence in aggregate analyses of HBSC data that focus on relationships between SES and adolescent health.

[1]  S. Cunningham-Burley,et al.  Contrasting lives, contrasting views? Understandings of health inequalities from children in differing social circumstances. , 2003, Social science & medicine.

[2]  Ichiro Kawachi,et al.  Income distribution and mortality: cross sectional ecological study of the Robin Hood index in the United States , 1996, BMJ.

[3]  C. Currie,et al.  Indicators of socioeconomic status for adolescents: the WHO Health Behaviour in School-aged Children Survey. , 1997, Health education research.

[4]  M. Overpeck,et al.  Material deprivation and self-rated health: a multilevel study of adolescents from 22 European and North American countries. , 2004, Social science & medicine.

[5]  C. Currie.  Socioeconomic circumstances among school-aged children in Europe and North America , 2001, Child well-being child poverty and child policy.

[6]  S. Nic Gabhainn,et al.  Health and health behaviour among young people , 2000 .

[7]  C. Roberts,et al.  Socio-economic inequalities and health , 2004 .

[8]  P. Gregg,et al.  Child Well-Being, Child Poverty and Child Policy in Modern Nations: What Do We Know? , 2001 .

[9]  C. Currie,et al.  Persistent socio-demographic differences in physical activity among Scottish schoolchildren 1990-2002. , 2005, European journal of public health.

[10]  O. Lundberg.  Causal explanations for class inequality in health--an empirical analysis. , 1991, Social science & medicine.

[11]  E. Goodman.  The role of socioeconomic status gradients in explaining differences in US adolescents' health. , 1999, American journal of public health.

[12]  V. Carstairs,et al.  Deprivation and health in Scotland. , 1990, Health bulletin.

[13]  P. West,et al.  Evidence on equalisation in health in youth from the West of Scotland. , 2004, Social science & medicine.

[14]  C. Currie,et al.  Young people's health in context. Health Behaviour in School-aged Childre (HBSC) study: international report from the 2001/2002 study. , 2004 .

[15]  P. Rossi,et al.  The measurement of SES in health research: current practice and steps toward a new approach. , 2003, Social science & medicine.

[16]  K. Pickett,et al.  Multilevel analyses of neighbourhood socioeconomic context and health outcomes: a critical review , 2001, Journal of epidemiology and community health.

[17]  P. Alderson.  Child Wellbeing, Child Poverty and Child Policy in modern nations , 2001 .

[18]  J. Mackenbach,et al.  Measuring the magnitude of socio-economic inequalities in health: an overview of available measures illustrated with two examples from Europe. , 1997, Social science & medicine.

[19]  Johan P. Mackenbach,et al.  Socioeconomic inequalities in the health of children and adolescents A comparative study of the five Nordic countries , 2000 .

[20]  F Johnson,et al.  Assessing socioeconomic status in adolescents: the validity of a home affluence scale , 2002, Journal of epidemiology and community health.

[21]  P. West,et al.  Lack of class variation in health in adolescence: an artefact of an occupational measure of social class? , 1991, Social science & medicine.

[22]  C. Currie,et al.  Dietary trends among Scottish schoolchildren in the 1990s. , 2001, Journal of human nutrition and dietetics : the official journal of the British Dietetic Association.

[23]  G. Duncan,et al.  Economic deprivation and early childhood development. , 1994, Child development.

[24]  P. West.  Health inequalities in the early years: is there equalisation in youth? , 1997, Social science & medicine.

[25]  J. Fortiana,et al.  Socio-economic Indexes in Surveys for Comparisons between Countries , 2004 .

[26]  T. Beattie,et al.  Socioeconomic status and adolescent injuries. , 1997, Social science & medicine.

[27]  M. Barrera,et al.  Pathways from family economic conditions to adolescents' distress: Supportive parenting, stressors outside the family, and deviant peers , 2002 .