Refining and validation of Family Socioeconomic Status Scale (FSESS) for health research in Egypt

Socioeconomic status (SES) is a key construct in public health and social research, yet its measurement varies across settings and over time. In Egypt, several existing SES scales are outdated and rely heavily on income, which has become increasingly unstable under current economic conditions. This study aimed to refine and psychometrically validate a concise Family Socioeconomic Status Scale (FSESS) that reflects contemporary socioeconomic conditions in Egypt. A community-based cross-sectional study was conducted using a multistage stratified cluster sampling design. Four governorates were selected to represent Egypt’s main geographic regions: Cairo (Greater Cairo), Dakahlia (Lower Egypt), Qena (Upper Egypt), and New Valley (Frontier Governorates). A total of 2,508 families were approached, 2,400 completed the survey (response rate 95.8%), and 2,090 were included in the final analysis. Data were collected through interviewer-administered Arabic questionnaires recorded electronically in English. The preliminary 20-item FSESS was developed based on literature review and expert consensus. Content validity was assessed by 13 public health experts. Exploratory and confirmatory factor analyses were performed using SPSS and R to assess construct validity and reliability. Exploratory factor analysis demonstrated adequate sampling adequacy (KMO = 0.89; Bartlett’s test p < 0.001) and supported a three-factor structure comprising education, occupation, and family income and possessions, represented by six core indicators. These factors accounted for 49% of the total variance. Confirmatory factor analysis supported the three-factor model, with acceptable to good model fit across multiple indices (CFI and IFI > 0.90; RMSEA < 0.08). The overall internal consistency of the scale was good (Cronbach’s alpha = 0.82). The refined FSESS provides a concise and methodologically sound measure of family socioeconomic position within the studied Egyptian settings. By capturing multiple dimensions of SES while remaining feasible for large surveys, the scale offers a practical framework for future health and social research. Further studies are warranted to examine its performance in additional populations and its associations with relevant health outcomes.