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Is the wealth index a proxy for consumption expenditure? A systematic review
L D Howe1, J R Hargreaves, S Gabrysch
1Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK. laura.howe@bristol.ac.uk
Background:
Many epidemiological studies require a measure of socioeconomic position. The monetary measure preferred by economists is consumption expenditure; the wealth index has been proposed as a reliable, simple alternative to expenditure and is extensively used.
Methods:
A systematic review was conducted of the agreement between wealth indices and consumption expenditure, summarising the agreement and exploring factors affecting agreement.
Results:
Seventeen studies using 36 datasets met the inclusion criteria. Of these, 22 demonstrated weak agreement, 10 moderate agreement, and four strong agreement. There was some evidence that agreement is higher: in middle-income settings; in urban areas; for wealth indices with a greater number of indicators; and for wealth indices including a wider range of indicators.
Conclusions:
The wealth index is mostly a poor proxy for consumption expenditure.
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