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Local distributions of wealth to describe health inequalities in India: a new approach for analyzing nationally representative household survey data, 1992-2008.

Bassani DG, Corsi DJ, Gaffey MF, Barros AJ - PLoS ONE (2014)

Bottom Line: Urban and rural decile cut-off values for India, for the six regions and for the 24 major states revealed large variability in wealth by geographical area and level, and rural wealth score gaps exceeded those observed in urban areas.The large variability in sub-national distributions of national wealth index scores indicates the importance of accounting for such variation when constructing wealth indices and deriving score distribution cut-off points.Such an approach allows for proper within-sample economic classification, resulting in scores that are valid indicators of wealth and correlate well with health outcomes, and enables wealth-related analyses at whichever geographical area and level may be most informative for policy-making processes.

View Article: PubMed Central - PubMed

Affiliation: Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada.

ABSTRACT

Background: Worse health outcomes including higher morbidity and mortality are most often observed among the poorest fractions of a population. In this paper we present and validate national, regional and state-level distributions of national wealth index scores, for urban and rural populations, derived from household asset data collected in six survey rounds in India between 1992-3 and 2007-8. These new indices and their sub-national distributions allow for comparative analyses of a standardized measure of wealth across time and at various levels of population aggregation in India.

Methods: Indices were derived through principal components analysis (PCA) performed using standardized variables from a correlation matrix to minimize differences in variance. Valid and simple indices were constructed with the minimum number of assets needed to produce scores with enough variability to allow definition of unique decile cut-off points in each urban and rural area of all states.

Results: For all indices, the first PCA components explained between 36% and 43% of the variance in household assets. Using sub-national distributions of national wealth index scores, mean height-for-age z-scores increased from the poorest to the richest wealth quintiles for all surveys, and stunting prevalence was higher among the poorest and lower among the wealthiest. Urban and rural decile cut-off values for India, for the six regions and for the 24 major states revealed large variability in wealth by geographical area and level, and rural wealth score gaps exceeded those observed in urban areas.

Conclusions: The large variability in sub-national distributions of national wealth index scores indicates the importance of accounting for such variation when constructing wealth indices and deriving score distribution cut-off points. Such an approach allows for proper within-sample economic classification, resulting in scores that are valid indicators of wealth and correlate well with health outcomes, and enables wealth-related analyses at whichever geographical area and level may be most informative for policy-making processes.

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Distribution of wealth scores by urban and rural areas of India across three rounds of the National Family Health Survey (NFHS).
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pone-0110694-g004: Distribution of wealth scores by urban and rural areas of India across three rounds of the National Family Health Survey (NFHS).

Mentions: The plotted distributions of household wealth scores by urban and rural areas for each survey round are given in Figures 4 and 5. For the most recent round of the NFHS, in 2005–6, score values for urban households across India ranged from 20 to 955, with a mean score of 547 (standard deviation of 230) and a median score of 552. In rural India, the mean score was 317 (standard deviation of 221) and the median score was 268.


Local distributions of wealth to describe health inequalities in India: a new approach for analyzing nationally representative household survey data, 1992-2008.

Bassani DG, Corsi DJ, Gaffey MF, Barros AJ - PLoS ONE (2014)

Distribution of wealth scores by urban and rural areas of India across three rounds of the National Family Health Survey (NFHS).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4214688&req=5

pone-0110694-g004: Distribution of wealth scores by urban and rural areas of India across three rounds of the National Family Health Survey (NFHS).
Mentions: The plotted distributions of household wealth scores by urban and rural areas for each survey round are given in Figures 4 and 5. For the most recent round of the NFHS, in 2005–6, score values for urban households across India ranged from 20 to 955, with a mean score of 547 (standard deviation of 230) and a median score of 552. In rural India, the mean score was 317 (standard deviation of 221) and the median score was 268.

Bottom Line: Urban and rural decile cut-off values for India, for the six regions and for the 24 major states revealed large variability in wealth by geographical area and level, and rural wealth score gaps exceeded those observed in urban areas.The large variability in sub-national distributions of national wealth index scores indicates the importance of accounting for such variation when constructing wealth indices and deriving score distribution cut-off points.Such an approach allows for proper within-sample economic classification, resulting in scores that are valid indicators of wealth and correlate well with health outcomes, and enables wealth-related analyses at whichever geographical area and level may be most informative for policy-making processes.

View Article: PubMed Central - PubMed

Affiliation: Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada.

ABSTRACT

Background: Worse health outcomes including higher morbidity and mortality are most often observed among the poorest fractions of a population. In this paper we present and validate national, regional and state-level distributions of national wealth index scores, for urban and rural populations, derived from household asset data collected in six survey rounds in India between 1992-3 and 2007-8. These new indices and their sub-national distributions allow for comparative analyses of a standardized measure of wealth across time and at various levels of population aggregation in India.

Methods: Indices were derived through principal components analysis (PCA) performed using standardized variables from a correlation matrix to minimize differences in variance. Valid and simple indices were constructed with the minimum number of assets needed to produce scores with enough variability to allow definition of unique decile cut-off points in each urban and rural area of all states.

Results: For all indices, the first PCA components explained between 36% and 43% of the variance in household assets. Using sub-national distributions of national wealth index scores, mean height-for-age z-scores increased from the poorest to the richest wealth quintiles for all surveys, and stunting prevalence was higher among the poorest and lower among the wealthiest. Urban and rural decile cut-off values for India, for the six regions and for the 24 major states revealed large variability in wealth by geographical area and level, and rural wealth score gaps exceeded those observed in urban areas.

Conclusions: The large variability in sub-national distributions of national wealth index scores indicates the importance of accounting for such variation when constructing wealth indices and deriving score distribution cut-off points. Such an approach allows for proper within-sample economic classification, resulting in scores that are valid indicators of wealth and correlate well with health outcomes, and enables wealth-related analyses at whichever geographical area and level may be most informative for policy-making processes.

Show MeSH