Abstract Background: Socioeconomic status (SES) is a criterion consisting of several components that encompass socioeconomic and cultural dimensions. This study aimed to design and develop a methodological guideline for calculating a single summary index (SSI) using the contributing variables of SES in a family unit. Methods: The data consisted of 18 700 urban and 19 200 rural households. Effective components of SES were extracted using two-step factor analysis and the structural equational modeling (SEM) method for both populations separately with AMOS software. Then, in order to customize and validate the weight of each component, the analytic hierarchy process (AHP) method was performed by a panel of experts. Finally, the SES index computational tool was developed as an SSI using all effective components by Excel software. Statistical analysis was done with SPSS software version 21. Results: In rural areas, the four wealth components of education, job, income, and family size were recognized as effective socioeconomic factors. Yet, in urban areas, family size was disregarded as an effective factor. In both rural and urban communities the three welfare components of appropriate nutrition, appropriate home appliance, and appropriate housing were similarly effective. The SES of rural population had a homogeneous distribution, while urban population did not follow a particular trend. Conclusion: The SES index impacts all aspects of life, especially health status. The introduced method is comprehensive and applicable to both rural and urban populations. Due to ever-changing lifestyles, constant technological advances, and socio- political changes in each society, the tool requires modification in a specific time intervals. Keywords: Health, Lifestyle, Inequality, Socioeconomic status, Wealth, Welfare Introduction Socioeconomic status (SES), which is also termed SES index, deprivation index, and inequality index, is defined as the level of access of people to financial, social, and cultural resources. 1 It has a major impact on all aspects of a society’s quality of life, especially on health-related issues. This is why using an accurate SES index can prevent inappropriate distribution of healthcare services, risks of catastrophic expenditures, and hidden subsidies of poor to rich, particularly in developing or less developed countries. 2 In many studies, the association between SES components and health indices has been examined, using a variety of indicators such as mortality index among different age and gender groups, maternal mortality index, communicable and non-communicable disease patterns, nutritional disorders index, health related behavior index, index of productivity, and access to health services in societies. 2,3 In addition to health-related issues, SES components have been widely used in studies focused on social and behavioral topics and on educational systems. 4,5 Other studies have also investigated the impact of SES on academic achievement, learning disabilities, risk-sharing age groups, depression, anxiety, committing crimes, and so forth. 6,7 The SES index consists of several components involving socio-economic and cultural dimensions. In different studies, various components have been used Developing a household socioeconomic status index tool for health studies in Iran: An analytic hierarchy process approach Sareh Shakerian 1 ID , A. Hamid Zafarmand 2 ID , Shahram Yazdani 3 ID , Sediqe Shafiei 4* ID 1 Assistant Professor, Department of Community Based Education of Health Sciences, School of Management of Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2 Associate Professor, Department of Community Oral Health, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran 3 Professor, School of Management of Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran 4 Assistant Professor, Department of Community Oral Health, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran *Corresponding Author: Sediqe Shafiei, Email: s_shafiei@sbmu.ac.ir Received: September 13,2021, Accepted: November 24,2022, ePublished: December 29, 2022 https://johoe.kmu.ac.ir 10.34172/johoe.2022.09 Vol. 11, No. 4, 2022, 222-230 Original Article Citation: Shakerian S, Zafarmand AH, Yazdani S, Shafiei S. Developing a household socioeconomic status index tool for health studies in Iran: an analytic hierarchy process approach. J Oral Health Oral Epidemiol. 2022;11(4):222-230. doi:10.34172/johoe.2022.09 Journal of Oral Health and Oral Epidemiology