Preliminary evaluation of a Bangladesh-adapted Kuppuswamy socioeconomic status scale in rural hypertensive adults

Background: A Bangladesh-adapted Kuppuswamy socioeconomic status (SES) scale was developed by modifying the education, occupation, and income domains of the original instrument but had not undergone empirical evaluation. We aimed to examine its structural coherence (intercorrelation of the three components), the agreement between fixed and empirically derived component weights, convergent association with respondents’ own education, exploratory associations with health-related outcomes, and the consequences of collapsing the five SES categories into three. Methods: Secondary analysis of 461 hypertensive adults from a single rural sub-district of Bangladesh. Component intercorrelation was described with Spearman correlations and Factor Analysis using the Principal Component extraction method; agreement between fixed and PCA-derived weights was assessed; convergent association was examined against respondents’ own education; associations with medication adherence and blood pressure were examined across three SES categories as exploratory health-related associations; and category-collapse was checked with linear contrasts and a Jonckheere–Terpstra test. Results: The three components were positively but modestly intercorrelated (Spearman rho 0.28–0.39). Fixed and PCA-derived weights ranked participants near-identically (rho=0.989). The composite correlated weakly, and only partly independently, with respondents’ education (rho=0.253; 0.274 after removing the education overlap). Medication adherence rose across SES categories (η2=0.142), driven mainly by the lowest group; blood pressure did not differ (P=0.08 and 0.23). The true upper SES range was essentially untested (n=2). Conclusion: In this single rural, hypertensive sample the adapted scale showed positive intercorrelation among its components, weak and only partly independent convergent association with education, and a modest association with adherence at the lower socioeconomic range. These findings are promising but preliminary; further evaluation across the full socioeconomic range, in urban as well as rural settings, and against an independent wealth criterion is needed before routine use.