- Socioeconomic status (SES) is a combination of social and economic factors that is widely used in social sciences to measure one's position within a hierarchical social structure. It influences health and disease. - Several SES scales have been developed for the Indian population, including the Udai Pareek scale for rural areas, Kuppuswamy scale for urban areas, and BG Prasad scale which considers income, education, and occupation. - Regular updates to the income criteria in SES scales are needed due to inflation and currency depreciation over time to accurately classify populations. Consumer price indices are often used to revise the income cut-offs in scales like BG Prasad to ensure they remain relevant

1. DR.V. XAVIER, MBBS, MBA,PGDHM
Alumni , Stanley Medical College Chennai

2.  Socioeconomic status (SES) is one of the most
important social determinants of health and disease,
thus, a widely studied construct in the social
sciences.1
 SES influences the accessibility, affordability,
acceptability and actual utilization of available
health facilities2
 Socioeconomic status (SES) is a combination of
social and economic variables
• Ref:
• 1.M Bairwa, M Rajput, S Sachdeva :Kuppuswamy’s Socioeconomic Scale: Social Researcher Should
Include Updated Income Criteria: Indian J Community Med. 2013 Jul-Sep; 38(3): 185–186
• Agarwal AK. Social classification: The need to update in the present scenario. 2008:33(1); 50-1

3.  A composite measure that typically
incorporates economic, social, and work status1
.
 Economic status is measured by income.
 Social status is measured by education, and
 work status is measured by occupation.
• Each status is considered an indicator.
• These three indicators are related but do not overlap
Ref:
1.Adler, N.E., Socioeconomic status and health: The challenge of the gradient. American psychologist, 1994.49(1): p. 15.

4.  Low SES population presenting more
commonly with nutritional deficiency and
communicable diseases and
 High SES showing more of obesity and
noncommunicable diseases;
 Access to healthcare with high SES showing a
better access.
Ref: Sunil K. Raina: Use of Socioeconomic Status Scales in Medicine and Public Health :J Family
Med Prim Care. 2015 Jan-Mar; 4(1): 156

5.  Status inequalities between individuals are
common, so it becomes a quantitative issue to
determine how much social inequality
qualifies as stratification.
 In general, the more complex the society, the
more numerous the layers or strata of social
differentiation1
• Ref:
• 1.Grusky, David B. (2011). “Theories of Stratification and Inequality”. In Ritzer, George and J. Michael Ryan
(eds.). The Concise Encyclopedia of Sociology. Wiley-Blackwell. pp. 622–624. Retrieved 23 June 2014

6.  The position that an individual or family
occupies with reference to the prevailing
average standards of cultural and material
possessions, income, and participation in
group activity of the community

7. 1. Understand the distribution of population
based on SES1
2. To develop a uniform system of socioeconomic
classification of the population universally
based on the income with scientific basis
3. Resources are scarce
a. Need to identify the most needy
b. Difficulty in identifying the exact number of people
living below the poverty line (BPL families) in India1
Ref :
1. Tendulkar SD. New Delhi: Government of India; 2009. Report of the expert group to review the
methodology for estimation of poverty. Planning commission; p. 29

8.  Hollingshead scale, (The Hollingshead Four
Factor Index of Socioeconomic Status is a
survey designed to measure social status of an
individual based on four domains: Marital
status, retired/employed status, educational
attainment, and occupational prestige.)
 Mac Arthur scale (Domains: Education,
income, occupational status and wealth)
Ref: Hollingshead, A. A. (1975). Four-factor index of social status. Unpublished manuscript, Yale University, New Haven, CT.

9.  (NFHS - II) had used the Standard of Living Index
(SLI) scale 1
 Contains 11 items viz. house type, source of
lighting, toilet facility, main fuel for cooking,
source of drinking water, separate room for
cooking, ownership of the house, ownership of
agricultural land, ownership of irrigated land,
ownership of livestock, ownership of durable
goods
 Used for measuring the SES both urban and rural
areas for the entire country
Ref:NFHS-2, India, 1998-99

10.  The NFHS-3 wealth index is
based on the following 33
assets and housing
characteristics:
NFHS-3, India, 2005-06

11.  Household
electrification
 Type of
windows
 Drinking water
source
 Type of toilet
facility
 Type of flooring
 Material of
exterior walls
 Type of roofing
 Cooking fuel
 House
ownership
 Number of
household
members per
sleeping room
Ref:NFHS-3, India, 2005-06
• Ownership of a bank
or post-office account
• Ownership of a
mattress,
• A pressure cooker,
• A chair, a cot/bed, a
table, an electric fan,
a radio/transistor,
• A black and white
television, a color
television,
• A sewing machine
• A mobile telephone,
• Any other telephone
• A computer,
• A refrigerator,
• A watch or clock,
• A bicycle,
• A motorcycle or
scooter,
• An animal-drawn
cart,
• A car,
• A water pump,
• A thresher,
• A tractor

12.  Udai Pareek and G. Trivedi (1964)
 Kuppuswamy scale 1962
 B G Prasad classification proposed in the year
1961
Ref:
• Prasad BG. Changes proposed in social classification of Indian families. J Indian Med Assoc.
1970;55:98–9.
• Pareekh U. Delhi: Mansayan; 1981. Mannual of socio economic status (rural)
• Gupta MC, Mahajan BK. Social environment. In: Guptha MC, editor. Text book of preventive and
social medicine. 3rd ed. New Delhi: Jaypee Publications; 2005. p. 117.

13. Criterias Udai pareek B. Kuppu swamy B.G. Prasad
Income x Total family
income
Per capita income
Education + Edu of family
head
X
Occupation + Occ of family
head
X
Caste + X X
Land + X X
Social participation + X X
Family type + X X
Family size + X X
Type of house + X X
Farm power + X X
Material possession + X X
Composite score + + X
Rural or urban R U R & U
• .Ref
• 1.Kuppuswamy B. Manual of Socioeconomic Status (Urban) 1st ed. Delhi: Manasayan; 1981. pp. 66–72
• 2.Prasad BG. Changes proposed in social classification of Indian families. J Indian Med Assoc. 1970;55:98–9.
• 3.Pareekh U. Delhi: Mansayan; 1981. Mannual of socio economic status (rural

14.  Udai Pareek and G. Trivedi (1964) attempts to
examine the socio-economic status for the rural
or mixed population only
 This scale consists of a manual and one
information blank
 This scale has nine factors which assess the
socioeconomic status of the individual

15.  Caste
 Occupation
 Education
 Social
 participation
 Land
 House
 Farm powers
 Material possession
 Family

16. 1.Caste 2.Occupation
Scheduled caste 1 Labour 1
Lower caste 2 Caste occupation 2
Artisan caste 3 Business 3
Agricultural caste 4 Independent profession 4
Prestige caste 5 Cultivation 5
Dominant caste 6 Service 6
3.Education 4.Social participation
Illiterate 0 Member of one
organization
1
Can read only 1 Member of > 1
organization
2
Can read and write 2 Office holder 3
Primary 3 Wider public leader 6
Middle 4
High school 5
Graduate 6• Ref: Holyachi S: Socio economic scales – An update: Annals of comm health V1:issue 1:p24

17. 5. Land Score 7. Farm power Score 9.Family Score
No land 0 No drought animal 0 Type
< 1 Acre 1 1-2 drought animals 2 Single 1
1- 5 Acres 2 3-4 drought animal 4 Joint 2
5-10 Acres 3 Or one prestige animal 4 Extended 3
10-15 Acres 4 5-6 drought animal or tractor 6 Upto 5 2
15-20 Acres 5 Distinct
features
2
>20 Acres 6
6. House Score 8. Material possession Score
No home 0 Bullock -cart 1
Hut 1 Cycle ,Radio , Chair 1
Katcha
house
2 Improved agri implements
Mixed house 3 Television 3
Pucca house 4 Mobile 4
Mansion 6 Refrigerators 8

18.  After filling the information ,and scoring the
individual items, the total score is summed up.
 With the help of the key provided in the
manual, total score is interpreteding terms of
the class.

19.  This scale does not emphasize the income
aspect and can only be used for rural subjects

20.  Above 43 Upper Class (I)
 33-42 Upper Middle Class (II)
 24-32 Middle Class (III)
 13-23 Lower Middle Class (IV)
 Below 13 Lower Class (V)

21.  Modified BG Prasad socioeconomic scale is
widely used to determine the socioeconomic
status .
 The Consumer Price Index (CPI) for industrial
workers (IW) is used to calculate updated
income categories

22.  Income ranges in the scale lose their relevance
following the depreciation in the value of the
rupee1 .
 Steady inflation, lower interest rates, and
country’s current account deficits are the main
factors contributing to fall in the value of
currency2.
 Therefore, it is needed to update the scale
regularly for socioeconomic classification of study
populations. 3
1.Ref:Kuppuswamy B. Manual of Socioeconomic Status (Urban) 1st ed. Delhi: Manasayan; 1981. pp. 66–72.
2.Mishra D, Singh HP. Kuppuswamy’s socioeconomic status scale - A revision. Indian J Pediatr. 2003;70:273–4
.
3.Kumar P. Social classification - Need for constant updating. Indian J Community Med. 1993;18:60–1.

23.  Kumar had tried to update Prasad Scale’s
income limits using consumer price index (CPI)
 Kuppuswamy socioeconomic scale was revised
with CPI .
 Linking of the scale with price index makes it
relevant and meaningful and also provides a
opportunity for constant updation .
• Ref:
• 1.M Bairwa, M Rajput, S Sachdeva :Kuppuswamy’s Socioeconomic Scale: Social Researcher Should
Include Updated Income Criteria: Indian J Community Med. 2013 Jul-Sep; 38(3): 185–186

24.  Definition: A comprehensive measure used for
estimation of price changes in a basket of goods
and services representative of consumption
expenditure in an economy is called consumer
price index
• Ref: http://economictimes.indiatimes.com/definition/consumer-price-index

25.  The BG Prasad scale was formulated in
1961Consumer Price Index (CPI) for 1960 as
100.
 This was revised in 1982 by introducing a
linking factor of 4.93 to convert CPI (1982)
from the new base of 100 to the old base CPI
(1960).
 Again a need was felt in 2001 to revise the
base, which was done by introducing the
linking factor of 4.63.

26.  (CPI [IW]× 4.63) × 4.93 ÷ 100.
 [ 237 ]× 4.63) × 4.93 ÷ 100.
 = 54.09738
Class Prasad’s Classification
(1961) In Rupees
New Starting classes
before they are
rounded off
Modified Prasad’s
Classification after
rounding off to the
nearest Rs. 10/=
I 100 & above 5410 5410 & above
II 50-99 2705 2710 – 5409
III 30-49 1623 1620 – 2709
IV 15-29 811 810
V Below 15 811 Below 810

27.  It is only income-based scale

28.  The most widely used scale for urban population
was devised by Kuppuswamy in 1976.
 Kuppuswamy scale is a composite score of
education and occupation of the head of the family
along with monthly income of the family, which
yields a score of 3-29.
 This scale classifies the study populations into
high, middle, and low SES
 To get current income group, a conversion factor
calculated based on current All India Consumer
Price Index (AICPI) is applied

29.  Manual
 Two information blanks (one for the person
concerned and second for the father or guardian)
 Score card
• The information is collected in the devised
Information blanks and with the help of
the score card the status score is obtained.
• On the basis of the total score, the
respective class is found out.
Scoring:

30. • Ref:Kuppuswamy B. Manual of Socioeconomic Status (Urban) 1st ed. Delhi: Manasayan; 1981. pp. 66–72.

31.  26 –29 Upper (I)
 16 –25 Upper Middle (II)
 11 –15 Middle (III)
 05 –10 Lower Middle (IV)
 < 4 Lower (V)

32.  Steady inflation and consequent fall in the
value of currency make the economic criteria
in the scale less relevant.
Ref:
.Mishra D, Singh HP. Kuppuswamy’s socioeconomic status scale - A revision. Indian J Pediatr. 2003;70:273–4
.Kumar P. Social classification - Need for constant updating. Indian J Community Med. 1993;18:60–1.

33.  SES is a predictor of health status
 Socioeconomic status (SES) is a combination of social and
economic variables
 SES Scales help to develop a uniform system of
socioeconomic classification of the population universally
based on the income with scientific basis
 Udai Pareek and G. Trivedi scale, Kuppuswamy scale 1962,
B G Prasad classification are some Indian SES scales .
 Steady inflation, lower interest rates, and country’s current
account deficits are the main factors contributing to fall in
the value of currency, so, it is needed to update the scale
regularly for socioeconomic classification of study
populations

34. Criterias Udai pareek B. Kuppu swamy B.G. Prasad
Income x Total family
income
Per capita income
Education + Edu of family
head
X
Occupation + Occ of family
head
X
Caste + X X
Land + X X
Social participation + X X
Family type + X X
Family size + X X
Type of house + X X
Farm power + X X
Material possession + X X
Composite score + + X
Rural or urban R U R & U
• .Ref
• 1.Kuppuswamy B. Manual of Socioeconomic Status (Urban) 1st ed. Delhi: Manasayan; 1981. pp. 66–72
• 2.Prasad BG. Changes proposed in social classification of Indian families. J Indian Med Assoc. 1970;55:98–9.
• 3.Pareekh U. Delhi: Mansayan; 1981. Mannual of socio economic status (rural

35.  Thank u