The impact of socio-economic status on health related quality of life for children and adolescents with heart disease
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RESEARCH
Open Access
The impact of socio-economic status on health related quality of life for children and adolescents with heart disease Amy Cassedy1,2*, Dennis Drotar3, Richard Ittenbach1, Shawna Hottinger4, Jo Wray5, Gil Wernovsky6,7, Jane W Newburger8,9, Lynn Mahony10, Kathleen Mussatto11, Mitchell I Cohen12 and Bradley S Marino13
Abstract Background: Socioeconomic status (SES) is known to influence children’s health-related quality of life. Many SES indicators assess distinct dimensions of a family’s position rather than measuring the same underlying construct. Many researchers, however, see SES indicators as interchangeable. The primary aim of this study was to determine which measure of SES had the strongest impact on health-related quality of life. Methods: This is a secondary analysis of the Pediatric Cardiac Quality of Life Inventory Validation Study. The SES variables were family income, Hollingshead Index (occupational prestige), and highest parent educational attainment level. Health-related quality of life was measured using the Pediatric Cardiac Quality of Life Inventory. Correlations tested the relationship among the three SES indicators. Regression-based modeling was used to calculate the strength of the association between SES measures and the Pediatric Cardiac Quality of Life Inventory. Results: The correlations among the SES measures were moderately high, with the correlation between the Hollingshead Index and parental education being r = 0.62 (95% CI = 0.56-0.65). There were equally high correlations between family income and the Hollingshead (r = 0.61, 95% CI = 0.57-0.65) and a slightly lower correlation between family income and parental education (r = 0.55, 95% CI = 0.52-0.59). Family income had the highest explanatory value compared to the Hollingshead Index or parental educational attainment, while controlling for sex, race, current cardiac status, and original diagnosis, accounting for 4-5% of the variation in patient and parent Pediatric Cardiac Quality of Life Inventory Total score, respectively, compared to the other SES measures. Conclusion: Family income as an SES measure demonstrated the greatest fidelity with respect to health-related quality of life as measured by the Pediatric Cardiac Quality of Life Inventory across respondent groups and explained more of the variation compared to the Hollingshead Index or highest parental educational attainment.
Introduction Family income, occupational prestige, and educational attainment are measures of Socio-Economic Status (SES) that have been found to influence an individual’s life opportunities. Life opportunities can manifest themselves in various ways, such as availability of resources to an individual within the health care system or an individual’s * Correspondence: [email protected] 1 Department of Pediatrics, Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, Cincinnati, OH 45229, USA 2 Department of Sociology, McMicken
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