Socioeconomic Status in Pediatric Health Research: A Scoping Review.

Abstract

To conduct a scoping review of the literature to describe current conceptualization and measurement of socioeconomic status in pediatric health research. 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). 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. 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.