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Varghese JS, Adair LS, Patel SA, Bechayda SA, Bhargava SK, Carba DB, Horta BL, Lima NP, Martorell R, Menezes AMB, Norris SA, Richter LM, Ramirez-Zea M, Sachdev HS, Wehrmeister FC, Stein AD. Changes in asset-based wealth across the life course in birth cohorts from five low- and middle-income countries. SSM Popul Health 2021; 16:100976. [PMID: 34901377 PMCID: PMC8637637 DOI: 10.1016/j.ssmph.2021.100976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 11/16/2021] [Accepted: 11/18/2021] [Indexed: 01/08/2023] Open
Abstract
Background Temporally-harmonized asset-based measures of wealth can be used to study the association of life-course wealth exposures in the same scale with health outcomes in low- and middle-income countries (LMICs). The within-individual longitudinal stability of asset-based indices of wealth in LMICs is poorly understood. Methods Using data from five birth cohorts from three continents, we developed temporally-harmonized asset indices over the life course through polychoric principal component analysis of a common set of assets collected consistently over time (18 years in Brazil to 50 years in Guatemala). For each cohort, we compared the harmonized index to cross-sectional indices created using more comprehensive asset measures using rank correlations. We evaluated the rank correlation of the harmonized index in early life and adulthood with maternal schooling and own attained schooling, respectively. Results Temporally-harmonized asset indices developed from a consistently-collected set of assets (range: 10 in South Africa to 30 in Philippines) suggested that mean wealth improved over time for all birth cohorts. Cross-sectional indices created separately for each study wave were correlated with the harmonized index for all cohorts (Brazil: r = 0.78 to 0.96; Guatemala: r = 0.81 to 0.95; India: 0.75 to 0.93; Philippines: r = 0.92 to 0.99; South Africa: r = 0.84 to 0.96). Maternal schooling (r = 0.15 to 0.56) and attained schooling (r = 0.23 to 0.53) were positively correlated with the harmonized asset index in childhood and adulthood respectively. Conclusions Temporally-harmonized asset indices displayed coherence with cross-sectional indices as well as construct validity with schooling. Temporally-harmonized asset indices are useful to assess relative importance of wealth at different life stages with health on the same scale. Harmonized indices using a subset of assets were correlated with cross-sectional asset indices using all available assets in five LMIC birth cohorts. Harmonized indices displayed construct validity, as demonstrated by its correlation with schooling. Harmonized indices were robust to alternate specifications such as shorter lists of assets, study years, and factor extraction procedures.
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Key Words
- CLHNS, Cebu Longitudinal Health and Nutrition Survey
- COHORTS, Consortium On Health Orientated Research in Transitioning Societies
- EFA, Exploratory Factor Analysis
- INCAP, Institute of Nutrition for Central America and Panama
- LMIC, Low- and middle-income countries
- Life course epidemiology
- MCA, Multiple Correspondence Analysis
- NDBC, New Delhi Birth Cohort
- PCA, Principal Component Analysis
- SD, standard deviation
- SEP, Socio-economic position
- Social mobility
- Wealth index
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Affiliation(s)
- Jithin Sam Varghese
- Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA, USA
| | - Linda S Adair
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Shivani A Patel
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Sonny Agustin Bechayda
- USC-Office of Population Studies Foundation, Inc, University of San Carlos, Cebu City, Philippines.,Department of Anthropology, Sociology, and History, University of San Carlos, Cebu City, Philippines
| | | | - Delia B Carba
- USC-Office of Population Studies Foundation, Inc, University of San Carlos, Cebu City, Philippines
| | - Bernardo L Horta
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Natalia P Lima
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil
| | - Reynaldo Martorell
- Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA, USA.,Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Ana M B Menezes
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Shane A Norris
- SAMRC Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Linda M Richter
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Manuel Ramirez-Zea
- INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala
| | | | | | - Aryeh D Stein
- Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA, USA.,Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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