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Methodology for making cross-national comparisons is an area of increasing interest in social and public health related research. When studying socio-economic differences in health outcomes cross-nationally, there are several methodological issues of concern, especially when data is derived from self-reported questionnaires. Health Behaviour in School-aged Children (Currie et al. ) is a WHO cross-national study using school samples. HBSC provides comparable data, and thereby a unique opportunity to study associations between social indicators and health outcomes within an international perspective. In 2001/02 data was collected from a total of 162,323 children in 32 countries (Austria, Belgium, Canada, Croatia, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Greenland, Hungary, Ireland, Israel, Italy, Latvia, Lithuania, Macedonia, Malta, Netherlands, Norway, Poland, Portugal, Russia, Slovenia, Spain, Sweden, Switzerland, Ukraine, United Kingdom, USA.). Studies of social inequalities requires that a comparable measure of socio-economic position (SEP) is in use. HBSC has developed a proxy for social position measuring material wealth, the Family Affluence Scale (FAS). This paper studies FAS and whether it is comparable across population subgroups defined by country, age and gender. Initial analysis revealed that an item measuring perceived family wealth was a valid FAS item. Including this item in the FAS score will improve the reliability of FAS. Graphical log-linear Rasch models (GLLRM) showed that FAS contain differential item functioning (DIF) with respect to country, age, and gender as well as local dependency (LD) between items. During the analysis, test equating techniques where used to adjust for the test bias generated by DIF. We recommend that the equated scores are used whenever FAS is included as a variable. This study suggests that HBSC-FAS should contain five items (additional item: perceived family wealth) when analysing data from HBSC 2001/02, and furthermore that each country should adjust for the DIF or make use of the converted FAS scores provided. If using FAS as a proxy for social position at an international level, it is not advised to compare the absolute levels of FAS, but weigh the scale by ridit transformation. [ABSTRACT FROM AUTHOR]

This paper extends and further validates the quality-of-life/ community-healthcare model and measures developed by Rahtz and Sirgy (2000). The quality of life (QOL) model is based on the theoretical notion that community residents' satisfaction with healthcare services available within their community affects community quality of life and life satisfaction. This study extends the model and, in keeping with past research, posits that the bottom-up spillover from community QOL to life satisfaction is greater for those individuals with low personal health satisfaction, lower income, and old age. Data were collected from 1094 community residents in the East-Coast area of the United States. The results provide good support of the new model. Managerial implications and applications for the new model are discussed. [ABSTRACT FROM AUTHOR]