Construction and Validation of CAPSES Scale as a Composite Indicator of SES for Health Researches: An Application to Modeling Social Determinants of Cardiovascular Diseases

Background: The main objective of this study was to construct and validate a composite socio-economic status indicator, containing material capital, human capital, and social capital (CAPSES scale) and also appropriate it for CVDs in a large population-based study. Methods This cross-sectional study, the Urban HEART-2 project, was conducted in Tehran, Iran in 2011. A total of 34116 households covering 118542 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 as the main outcomes. A structural equation model (SEM) was used to construct CAPSES scale a composition index of SES. Criterion validity and Construct validity were used to assess this scale. Results A total of 91830 subjects consisting of 33884 (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 multiple logistic regression model. Conclusion The CAPSES scale was significantly associated with stroke and hypertension. Our findings showed that the CAPSES index can be useful for public health research.