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Methods to Measure Socio-Economic Inequalities in Health for Indian Adolescents

Authors:
Priyanka Parmar
Priyanka Parmar
Priyanka Parmar
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Manu Mathur at University College London
Manu Mathur
Georgios Tsakos at University College London
Georgios Tsakos
Richard G Watt at University College London
Richard G Watt
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Abstract

There is lack of standardized and reliable questionnaires to capture various behavioural aspects of subjective health of the population in India and this study was aimed to identify and validate methods and scales measuring determinants of socio-economic inequalities in health in context to Indian adolescents residing in diverse urban areas. In this study scales and questions from internationally validated questionnaires were adopted, and then reliability and validity tests were conducted through a cross sectional study on 1386 Indian adolescents residing in diverse areas of residence (slums, middle class and resettlement colonies) and standardized them to be used on Indian adolescent.
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ISDS Annual Conference Proceedings 2015. This is an Open Access article distributed under the terms of the Creative Commons Attribution-
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ISDS 2015 Conference Abstracts
Methods to Measure Socio-Economic Inequalities in
Health for Indian Adolescents
Priyanka Parmar*1, Manu R. Mathur1, Georgios Tsakos2 and Richard G. Watt2
1Public Health Foundation of India, Gurgaon, India; 2University College London, London, United Kingdom
Objective
To identify and validate methods and scales measuring determinants
of social inequalities in health in context to Indian adolescents
Introduction
Health inequalities are major global public health problem and
varies within and between countries [1]. LMICs particularly India,
are undergoing a phase of rapid economic development leading to an
increase in informal settlements or urban slums [2]. These settlements
exhibits extreme poverty and suffers from adverse health outcomes.
The worst affected are the adolescents because it is a crucial and
most vulnerable age when health behaviours and lifestyle choices
are established which affects their current and future health [3].
The current health system in many of the developing countries are
outdated and have either rudimentary health statistics or none. There
is lack of standardized and reliable questionnaires to capture various
behavioural aspects of subjective health of the population in India.
Thus, we aim to identify various measures of determinants of social
inequalities relevant to the Indian adolescent population context.
Methods
We adopted scales and questions from internationally validated
questionnaires, and conducted reliability and validity tests through
a cross sectional study on 1386 adolescents residing in diverse
areas of residence (slums, middle class and resettlement colonies)
and standardized them to be used on Indian adolescent population.
Questionnaire included important determinants of health: degree
of neighbourhood social capital, level of social support, health
related behaviours, self-rated health and key socio-demographic of
adolescents. The social capital scale was adapted from an adolescent
social capital scale used by Gage et al (2005) [4] and showed a
reasonable internal consistency (Cronbach’s Alpha = 0.63) when
tested on Indian adolescents. Social support scale was adapted from
the adolescent social support scale developed by Seidman et al (1995)
[5] and showed excellent internal consistency (Cronbach’s Alpha =
0.86) when tested on study population. Questions on health related
behaviours were taken from WHO HBSC survey which is a survey
of school children undertaken periodically in more than 40 countries
of the world [6].
Results
A social gradient in health inequalities was observed with a
sequentially detrimental health outcome at each lower level of areas
of residence.
Conclusions
The questionnaire was observed sensitive to LMICs setting and
consistent with both international as well as Indian adolescents
context. Studying both clinical and subjective health outcomes
in a population can provide important insights about different
explanations of various indicators of health, highlighting the complex
nature of inequalities. The questionnaire is useful in identifying social
inequalities in health to advance health equity among adolescents.
Conceptual Framework of Urban Health (Galea et al., 2005)
Keywords
Social Inequalities; Methods; Adolescents
Acknowledgments
This work was supported by a Wellcome Trust Capacity Strengthening
Award to the Public Health Foundation of India and a consortium of UK
universities.
References
1. Marmot M. Public Health Social determinants of health inequalities.
Lancet. 2005;365:1099–104.
2. Vlahov D, Freudenberg N, Proietti F, Ompad D, Quinn A, Nandi V, et
al. Urban as a determinant of health. J. Urban Heal. 2007;84.
3. Wiefferink CH, Peters L, Hoekstra F, Ten Dam G, Buijs GJ, Paulussen
TGWM. Clustering of health-related behaviors and their determinants:
Possible consequences for school health interventions. Prev. Sci. 2006.
p. 127–49.
4. Gage JC, Overpeck MD, Nansel TR, Kogan MD. Peer activity in the
evenings and participation in aggressive and problem behaviors. J.
Adolesc. Health. 2005;37:517.
5. Seidman E, Allen L, Lawrence Aber J, Mitchell C, Feinman J,
Yoshikawa H, et al. Development and validation of adolescent-
perceived microsystem scales: Social support, daily hassles, and
involvement. Am. J. Community Psychol. 1995;23:355–88.
6. Roberts C, Freeman J, Samdal O, Schnohr CW, de Looze ME, Nic
Gabhainn S, et al. The Health Behaviour in School-aged Children
(HBSC) study: methodological developments and current tensions.
Int. J. Public Health. 2009;54 Suppl 2:140–50.
*Priyanka Parmar
E-mail: priyachoudhary22@hotmail.com
Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * 8(1):e151, 2016
ResearchGate has not been able to resolve any citations for this publication.
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