Construction and validation of CAPSES scale as a composite indicator of SES for health research: an application to modeling social determinants of cardiovascular diseases

• Published in: BMC public health 2023-02, Vol.23 (1), p.293-293, Article 293
• Main Authors: Asadi-Lari, Mohsen, Majdzadeh, Reza, Mansournia, Mohammad Ali, Nedjat, Saharnaz, Mohammad, Kazem, Cheraghian, Bahman
• Format: Article
• Language: English
• Subjects: Adult; CAPSES scale; Cardiovascular diseases; Cardiovascular Diseases - epidemiology; Cellular telephones; Cerebral infarction; Cross-Sectional Studies; Diabetes mellitus; Disease; Economic aspects; Evaluation; Examinations; Expenditures; Female; Health care; Health care disparities; Heart; Households; Human capital; Humans; Hypertension; Hypertension - epidemiology; Iran; Iran - epidemiology; Job classification; Male; Microwaves; Middle Aged; Mortality; Multivariate statistical analysis; Myocardial infarction; Myocardial Infarction - epidemiology; Per capita; Personal computers; Population; Population studies; Prevention; Public health; Questionnaires; Regression models; Risk Factors; Sample size; SES; Social aspects; Social capital; Social Class; Social determinants; Social Determinants of Health; Socioeconomic factors; Socioeconomics; Stroke; Stroke - epidemiology; Surveys and Questionnaires; Urban HEART; Validity; Washers & dryers
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-023-15206-9

The main objective of this study was to construct and validate a composite socioeconomic status indicator containing material capital, human capital, and social capital (CAPSES scale) and also appropriate it for CVDs in a large population-based study. This cross-sectional study, the Urban HEART-2 project, was conducted in Tehran, Iran, in 2011. A total of 34,116 households covering 118,542 individuals were assessed in this study. A 14-parts questionnaire was completed for all selected households. All the gathered data were based on the participants' self-reports. Literacy, wealth index, expenditure, skill level, and Townsend index were used as SES indexes. CVDs, including Hypertension, Myocardial infarction, and stroke, were considered the main outcomes. A structural equation model (SEM) was used to construct a CAPSES scale and a composition index of SES. Criterion validity and Construct validity were used to assess this scale. A total of 91,830 subjects consisting of 33,884 (49%) men were included in this analysis. The mean age of the participants was 41.5 ± 11.37 years. Among the assessed participants, 5904(6.4%) reported hypertension, 1507(1.6%) myocardial infarction, and 407(0.4%) strokes. The overall weighted prevalence of self-reported cardiovascular events (hypertension, stroke, and MI) was 8.03% (95%CI: 7.8-8.2). Inverse associations were seen between the CAPSES scale and its domains with CVDs, adjusted for sex, age, BMI, smoking, and diabetes by a multiple logistic regression model. The CAPSES scale was significantly associated with stroke and hypertension. Our findings showed that the CAPSES index could be useful for public health research.