Abstract
Socioeconomic status (SES) is a critical measure that helps to correlate well-being and social status. SES plays a significant role in determining an individual’s quality of life, health, social position, and class. The widely accepted SES scales are the Kuppuswamy scale, BG Prasad scale, and Udai Pareekh scale. The income range is revised by using an online dedicated tool for this purpose. The scale is based on the income domain to decide the SES, which needs to be revised regularly based on the Consumer Price Index for Industrial Workers (CPI-IW). The study is the revised income range of the Kuppuswamy scale and BG Prasad scale as per the CPI-IW January 2021. However, all three scales have a few limitations and are not applicable to both the rural and urban areas at the same time.
Keywords: BG Prasad scale, Kuppuswamy scale, Socioeconomic status
Introduction
Socioeconomic status (SES) is an essential measure to assess an individual’s well-being. The socioeconomic condition is variably decided by the individual’s health-related quality of life and physiological well-being. The SES is essential to maintain health, health-seeking behavior, social class, and participation in socio-political and socio-cultural organizations.[1,2] In the academic area of social science and humanities, SES has played a crucial role in correlating the relation between SES with other associated phenomena. Individual or family income, educational level, quality of life, and other related aspects are strongly related to a sustainable livelihood.[2,3,4]
Various scholars and experts made several attempts to make a universal measure of SES for rural, urban, and semi-urban areas. The popular and well-accepted SES scale includes the Rahudkar scale 1960; BG Prasad scale 1961; Udai Pareek scale 1964; Jalota scale 1970, Kulshrestha scale 1972; Kuppuswamy scale 1976; and Bharadwaj scale 2001.
The Kuppuswamy scale and BG Prasad scale are living measures to assess socioeconomic condition. Both the scales are regularly revised as per the Consumer Price Index for Industrial Workers (CPI-IW). The month-wise CPI-IW value was compiled and released by the Labour Bureau under the Ministry of Labour and Employment, Government of India.[5,6] The present study attempts to revise the income range of the Kuppuswamy and BG Prasad SES scales as per the CPI-IW for January 2021. However, the Udai Pareek scale has not comprised any income indicator.
Data and Methods
The CPI-IW value of January 2021 is collected from the Labor Bureau’s website, Government of India. The revised income range of the Kuppuswamy and BG Prasad SES scales is calculated using a simple online calculator exclusively dedicated for this purpose.[7,8]
Results and Discussion
The Kuppuswamy scale [Tables 1 and 2] was prepared in 1976 which included three broad domains of SES, i.e. occupation, total family income, and education. Simply, the scale was modified from time to time due to the changing nature of per capita income. Initially (1976), the monthly income was initiated from 100 rupees (minimum) and 2,000 rupees (maximum). However, the range was not applicable in the present context. The BG Prasad scale [Table 3] comprises the income aspects that need to revise regularly. The Udai Pareek scale is a well-accepted measure of SES that included nine domains of SES, i.e. Caste, Occupation, House, Land, Education, Social Participation, Farm Power, Material Possessions, and Family Member [Tables 4 and 5]. The scale exempted the income criteria.
Table 1.
Score | |
---|---|
Education of Head of the Family | |
Professional degree | 7 |
Graduate or Postgraduate | 6 |
Intermediate or Post-high school diploma | 5 |
High school certificate | 4 |
Middle school certificate | 3 |
Primary school certificate | 2 |
Illiterate | 1 |
Occupation of Head of the Family | |
Professional | 10 |
Semi-Professional | 6 |
Clerical, Shop owner, farmer | 5 |
Skilled worker | 4 |
Semi-skilled worker | 3 |
Unskilled worker | 2 |
Unemployed | 1 |
Monthly Income of Family (as per CPI-IW January 2021) | |
≥18229 | 12 |
9115-18229 | 10 |
6836-9114 | 6 |
4557-6835 | 4 |
2734-4556 | 3 |
921-2733 | 2 |
≤920 | 1 |
Table 2.
Total Score | Socioeconomic Status Class |
---|---|
26-29 | Upper Class |
16-25 | Upper Middle Class |
11-15 | Middle Class |
5-10 | Lower Middle Class |
<5 | Lower Class |
Table 3.
Per Capita Monthly Income (as per CPI-IW January 2021) | Socioeconomic Status Class |
---|---|
≥2698 | Upper Class |
1349-2697 | Upper Middle Class |
809-1.48 | Middle Class |
405-808 | Lower Middle Class |
≤404 | Lower Class |
Table 4.
Components | Score | Components | Score |
---|---|---|---|
Caste | Education | ||
Scheduled Caste | 1 | Illiterate | 0 |
Lower Caste | 2 | Can read only | 1 |
Artisan Caste | 3 | Can read and write | 2 |
Agriculture Caste | 4 | Primary | 3 |
Prestige Class | 5 | Middle | 4 |
Dominant Class | 6 | High School | 5 |
Occupation | Graduate and above | 6 | |
None | 0 | Land | |
Laborer | 1 | No land | 0 |
Caste occupation | 2 | <1 acre | 1 |
Business | 3 | 1-5 acre | 2 |
Independent Profession | 4 | 5-10 acre | 3 |
Cultivation | 5 | 10-15 acre | 4 |
Service | 6 | 15-20 acre | 5 |
>20 acre | 6 | Material Possessions | |
Social Participation | Bullock cart | 0 | |
None | 0 | Cycle | 1 |
Member of one organization | 1 | Radio | 2 |
Member of more than one organization | 2 | Chairs | 3 |
Office holder in such an organization | 3 | Mobile Phone | 4 |
Wide public leader | 4 | Television | 5 |
House | Refrigerators | 6 | |
No house | 0 | Family Member | |
Hut | 1 | Up to 5 | 2 |
Kutcha house | 2 | >5 | 1 |
Mixed house | 3 | ||
Pucca house | 4 | ||
Mansion | 5 | ||
Farm Power | |||
No draft animals | 1 | ||
1-2 draft animals | 2 | ||
3-4 draft animals | 4 | ||
5-6 draft animals | 6 |
Table 5.
Socioeconomic status class | Total scale |
---|---|
Upper Class | >43 |
Upper Middle Scale | 33-42 |
Middle Scale | 24-32 |
Lower Middle Scale | 13-23 |
Lower Class | <13 |
All three scales are widely used and implemented by the social scientists and researchers involved in assessing the livelihood status, health, and quality of life. The scales help the researchers to classify the individual or families on different socioeconomic strata. They help to build relational studies and model building.
However, all three scales have a few limitations. The Kuppuswamy scale and BG Prasad scale are based on family income, which does not differentiate between joint and nuclear families.[9] Generally, the joint families have more income due to the greater number of earning members and diversified income sources (Shaikh and Pathak, 2017). Simultaneously, the Udai Pareek scale does not have any income domain that is crucial to maintain the SES. The scale’s income range was revised as per the CPI-IW, but it does not consider the CPI-AL. The scale is not well applicable in both rural and urban contexts. The Kuppuswamy scale is relevant to the urban and semi-urban areas. In contrast, the BG Prasad scale is applicable to the rural and urban areas, but it only considers income and exempted the other SES criteria.
Implications of SES Scale in Primary Care
The SES has a two-way relation in the access of healthcare facilities and maintenance of the quality of life. Several authors examine the interaction of the SES with healthcare access, patient behaviors, and access to universal health coverage.[10,11,12,13] The work of Olah et al. (2013)[10] shows that the availability of primary healthcare facilities significantly discriminates against the different socioeconomic backgrounds. The study revealed that lower socioeconomic background has limited the attainment of physicians which predominantly hampers the right to access primary care.[11] Low SES does not strongly decide the access to primary care and meeting with trained physicians.[11] However, these groups were deprived of access to avail specialists.[11]
In the above context, these specialized modified SES scales (namely Kuppuswamy scale, Udai Pareek scale, and BG Prasad scale) critically identify the different groups of people based on the socioeconomic attributes. They help to standardize the procedure of delineation of the different households into different SES classes. Likewise, these scales provide a wider scope to conduct comparative studies between different socioeconomic attributes with the relevant attributes of primary health research. The scales may provide effective results that help in the formation of healthcare policies, as per the needs of the different target groups. Also, these scales comprised different social and economic attributes in one platform which minimizes the ambiguity and enhances the deliberations of the development of necessary primary healthcare indicators.
Key Points
The people’s responses toward the prolonged practices of healthcare access are an essential component to the socioeconomic status. It is vital to delineate the social groups as per the requirement of the public health research that can easily formulate the behavioral pattern about the necessities of the access of healthcare physicians. Essentially, a standardized SES framework helps to categorize peoples/households’ backgrounds as per their social and economic characteristics. Further, access to universal health care facilities also affects the SES which is needed to address by policymakers as well as academicians.
SES is a characteristic to define the consumption and expenditure pattern of individuals and families. It is a crucial measure to identify the position of the individual in a society. The above-mentioned three scales are beneficial to determine the SES, but all have some limitations. To regularly revise the income range is essential, which helps to apply the scales to measure the current state of social status.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References
- 1.Saleem SM. Modified Kuppuswamy socioeconomic scale updated for the year 2019. Indian J Forensic Community Med. 2019;6:1–3. doi:10.18231/2394-6776.2019.0001. [Google Scholar]
- 2.Wani RT. Socioeconomic status scales- modified Kuppuswamy and Udai Pareekh's scale updated for 2019. J Family Med Prim Care. 2021;8:1846–9. doi: 10.4103/jfmpc.jfmpc_288_19. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Jana NC, Ghosh PK. Socioeconomic condition and quality of life in the Tribal areas of Orissa with special reference to Mayurbhanj District. Space Cult. 2015;3:25–41. [Google Scholar]
- 4.Saleem SM. Modified Kuppuswamy socioeconomic scale updated for the year 2020. Indian J Forensic Community Med. 2020;7:1–3. [Google Scholar]
- 5. [Last accessed on 2021 Mar 05]. http://labourbureau.gov.in/LBO_indnum.htm.
- 6.Ministry of Labour and Employment, Consumer Price Index for Industrial Workers (2016=100)-January, 2021. Government of India. [Last acessed on 2021 Mar 05]. Available from: http://labourbureau.gov.in/Press_Note_CPI_IW_JAN_2021_EH.pdf .
- 7.Sharma R. Online interactive calculator for real-time update of the Kuppusway's socioeconomic status scale. [Last accessed on 2021 Mar 9]. Available from: https://scaleupdate.weebly.com/real.html .
- 8.Sharma R. Online interactive calculator for real-time update of the B G Prasadsocio-economic status scale. [Last accessed on 2021 Mar 9]. Available from: https://prasadscaleupdate.weebly.com/
- 9.Shaikh Z, Pathak R. Revised Kuppuswamy and B G Prasad socioeconomic scales for 2016. Int J Community Med Public Health. 2019;4:997–9. [Google Scholar]
- 10.Olah ME, Gaisana G, Hwang SW. The effect of socioeconomic status on access to primary care:An audit study. CMAJ. 2013;185:E263–9. doi: 10.1503/cmaj.121383. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 11.Lueckman SL, Hoebel I, Roick J, Markert J, Spallek J, Knesebeck OV. Socioeconomic inequalities in primary-care and specialist physician visits:A systematic review. Int J Equity Health. 2021;20:58. doi: 10.1186/s12939-020-01375-1. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 12.Bernheim SM, Ross JS, Krumbolz HM, Bradley EH. Influence of patients'socioeconomic status on clinical management decisions:A qualitative study. Ann Fam Med. 2008;6:53–9. doi: 10.1370/afm.749. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 13.Moscrop A, Ziebland S, Roberts N, Papanikitas A. Asystematic review of reasons for and against asking patients about their socioeconomic contexts. Int J Equity Health. 2019;18:112. doi: 10.1186/s12939-019-1014-2. [DOI] [PMC free article] [PubMed] [Google Scholar]