Can we monitor socioeconomic inequalities in health? A survey of U.S. health departments' data collection and reporting practices.

Nancy Krieger · J T Chen · Gregory D. Ebel

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Health disparities and outcomes Public Health and Social Inequalities Health and Medical Studies

Abstract

OBJECTIVE: To evaluate the potential for and obstacles to routine monitoring of socioeconomic inequalities in health using U.S. vital statistics and disease registry data, the authors surveyed current data collection and reporting practices for specific socioeconomic variables. METHODS: In 1996 the authors mailed a self-administered survey to all of the 55 health department vital statistics offices reporting data to the National Center for Health Statistics (NCHS) to determine what kinds of socioeconomic data they collected on birth and death certificates and in cancer, AIDS, and tuberculosis (TB) registries and what kinds of socioeconomic data were routinely reported in health department publications. RESULTS: Health departments routinely obtained data on occupation on death certificates and in most cancer registries. They collected data on educational level for both birth and death certificates. None of the databases collected information on income, and few obtained data on employment status, health insurance carrier, or receipt of public assistance. When socioeconomic data were collected, they were usually not included in published reports (except for mothers educational level in birth certificate data). Obstacles cited to collecting and reporting socioeconomic data included lack of resources and concerns about the confidentiality and accuracy of data. All databases, however, included residential addresses, suggesting records could be geocoded and linked to Census-based socioeconomic data. CONCLUSIONS: U.S. state and Federal vital statistics and disease registries should routinely collect and publish socioeconomic data to improve efforts to monitor trends in and reduce social inequalities in health.

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References

1992Overcoming the absence of socioeconomic data in medical records: validation and application of a census-based methodology.1993The Increasing Disparity in Mortality between Socioeconomic Groups in the United States, 1960 and 1986 1996Inequality in income and mortality in the United States: analysis of mortality and potential pathways 1993Racism, Sexism, and Social Class: Implications for Studies of Health, Disease, and Well-being 1996Income distribution and mortality: cross sectional ecological study of the Robin Hood index in the United States 1967Social Class, Life Expectancy and Overall Mortality 1989NATIONAL TRENDS IN EDUCATIONAL DIFFERENTIALS IN MORTALITY 1990Race or class versus race and class: mortality differentials in the United States

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