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Socioeconomic Status in Pediatric Health Research: A Scoping Review
Alicia G Kachmar1, Cynthia A Connolly1, Sharon Wolf2
1Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA.
Objective:
To conduct a scoping review of the literature to describe current conceptualization and measurement of socioeconomic status in pediatric health research.
Study Design:
Four databases were used to identify relevant studies, followed by selection and data extraction. Inclusion criteria for studies were the following: enrolled subjects <18 years old, included a health-related outcome, published from 1999 to 2018, and explicitly measured socioeconomic status (SES).
Results:
Our literature search identified 1768 publications and 1627 unique records. After screening for duplication and relevance, 228 studies satisfied the inclusion criteria, with 75% (n = 170) published since 2009. There were 52 unique singular measures and an additional 20 composite measures. Income-related measures were used in 65% of studies (n = 147) and measures of education in 42% (n = 95). The majority of studies using census-derived variables or insurance status were conducted within the previous 10 years.
Conclusions:
Pediatric studies use a variety of SES measures, which limits comparisons between studies. Few studies provide an evidenced-based rationale that connects the SES indicator to the health outcome, but the majority of studies do find a significant impact of SES on outcomes. SES should be comprehensively studied so that meaningful measures can be used to identify specific SES mechanisms that impact child health.
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