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Int J Environ Res Public Health. 2020 Mar 5;17(5). pii: E1700. doi: 10.3390/ijerph17051700.

Measuring Child Socio-Economic Position in Birth Cohort Research: The Development of a Novel Standardized Household Income Indicator.

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Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, 10126 Torino, Italy.
ISER, University of Essex, Colchester CO4 3SQ, UK.
Research Team on Early Life Origin (EAROH), Université de Paris, CRESS, INSERM, INRA, F-75004 Paris, France.
Centre for Behavioural Science and Mental Health, Istituto Superiore di Sanità, 00161 Rome, Italy.
Childhood and Environment Programme, ISGlobal, 08003 Barcelona, Spain.
Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), 08003 Barcelona, Spain.
CIBER Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain.


The assessment of early life socioeconomic position (SEP) is essential to the tackling of social inequalities in health. Although different indicators capture different SEP dimensions, maternal education is often used as the only indicator in birth cohort research, especially in multi-cohort analyses. Household income, as a direct measure of material resources, is one of the most important indicators, but one that is underused because it is difficult to measure through questionnaires. We propose a method to construct a standardized, cross-cohort comparable income indicator, the "Equivalized Household Income Indicator (EHII)", which measures the equivalized disposable household income, using external data from the pan-European Union Statistics on Income and Living Conditions (EUSILC) surveys, and data from the cohorts. We apply this method to four studies, Piccolipiù and NINFEA from Italy and ELFE and EDEN from France, comparing the distribution of EHII with other SEP-related variables available in the cohorts, and estimating the association between EHII and child body mass index (BMI). We found that basic parental and household characteristics may be used, with a fairly good performance, to predict the household income. We observed a strong correlation between EHII and both the self-reported income, whenever available, and other individual socioeconomic-related variables, and an inverse association with child BMI. EHII could contribute to improving research on social inequalities in health, in particular in the context of European birth cohort collaborative studies.


birth cohorts; children; income; socioeconomic position

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