The challenges of measuring socioeconomic inequality in pharmacoepidemiology studies

Social conditions like socioeconomic status (SES) are critical sources of health disparities. In pharmacoepidemiology research, our ability to measure SES in retrospective, real-world clinical data remain challenged by a lack of patient-reported data. Some broadly accepted concepts can be measured at the individual level, such as income, poverty, and education. Community-level measures such as the Centers for Disease Control and Prevention's Social Vulnerability Index also exist. After reflecting on these existing measures and discussing the challenges for leveraging them with real-world data, we offer three recommendations that we believe could improve the ability of pharmacoepidemiologists to better measure and interrogate the effect of SES in their own research. These recommendations include a greater collection of patient-reported metrics, reduced reliance on ZIP Codes and ZIP Code Tabulation Areas for creating community-level measures of deprivation, and the inclusion of GIS and demography specialists within pharmacoepidemiology teams. This article is part of a Special Collection on Pharmacoepidemiology.