Comparison of the Associations of Different Socio-economic Indices with Various Indicators of Child Malnutrition in the Philippines

Abstract

Objectives: To compare associations between different indices of socio-economic status (SES) and child malnutrition.  Methods: A cross-sectional survey in poor urban areas in the Philippines collected information on child wasting, stunting, anemia, iron deficiency, and vitamin A deficiency, as well as data to calculate three measures of SES: household income; a Philippines government measure using housing conditions, income, education, and occupation; and a wealth index calculated from ownership of durable goods and other factors. Results: All forms of malnutrition were associated with all three SES measures; however, the government measure and the wealth index were more strongly associated. The odds ratios for anemia comparing the poorest group to the richest group were 1.7 for household income, 3.3 for the government measure, and 3.5 for the wealth index.  Similarly, for iron deficiency, the odds ratios were 1.5 for household income, 2.9 for the government measure, and 2.4 for the wealth index. The odds ratios for vitamin A deficiency were 3.4 for income, 3.4 for the government measure, and 11.9 for the wealth index. In addition, the correlations with anthropometric z-scores, hemoglobin, ferritin, and retinol binding protein concentrations were higher for wealth index than for household income when analyzed as continuous variables. Conclusions: In this study, measurements of wealth based on a broader variety of household characteristics were better correlated with malnutrition than household income alone. Estimates of SES in surveys assessing nutritional status should thus be based on a broader mix of data than just household income.