Development and validation of a district-level index of socioeconomic development for India

Abstract Introduction Socioeconomic development influences population health outcomes. The coexistence of rapid economic growth and persistent health inequalities in India underscores the need for community-level assessments of socioeconomic development. We created and validated four distinct multidimensional indices of socioeconomic development at the district level in India using separate data sources and two different methods. Methods Using data from the 2011 Census of India and the National Family Health Survey-4 (NFHS-4), four indices were constructed through principal components analysis (PCA) and percentile ranking. These indices covered sociodemographic, socioeconomic, housing, and community infrastructure domains. The indices were assessed for construct and criterion validity, examining their ability to capture the latent constructs of socioeconomic development and their relationship with health outcomes. Results All four indices suggested geographic disparities in socioeconomic development across India, with development lower in central regions and higher in southern states. They all demonstrated good construct validity, particularly with NFHS-4 data. The indices exhibited strong internal and external concurrent validity, aligning with the Multidimensional Poverty Index while also demonstrating predictive validity for nutritional health outcomes. Negative correlations with undernutrition in children and women and a positive correlation with being overweight or obese in adults were observed. Conclusion We successfully developed and validated multidimensional indices to measure socioeconomic development at the district level in India. Using both the 2011 Census and NFHS-4 ensured a comprehensive, multidimensional perspective on socioeconomic development and its health implications. The combination of PCA (for data-driven index creation) and percentile ranking (for relative comparisons) enhanced methodological robustness, providing a validated, scalable approach for assessing district-level development and its impact on public health in India. Future temporal and spatial analyses should explore the causal relationship between socioeconomic development and health outcomes.