Section outline

  • Lecture:  Basic analytic issues in HDR

    Given the complex social and biologic context in which health disparities are manifested, research in this areas requires nuanced application of statistical concepts related to confounding, mediation, moderation, and clustering. In this lecture, we will highlight aspects of statistical analysis of particular relevance to health disparities, including how to quantify disparities and evaluate determinants of inequalities, how to best build multivariate models, how to investigate race/SES interactions, principles of sub-group reporting and statistical power in health disparities research, as well as an overview of multilevel analyses.

    Faculty:  Anusha M Vable

    Location (Access restricted to registered students): Zoom URL

    • Session Slides:

    • Session Audio/Video Recording (Access restricted to registered students):

    • Watch -Live Lecture Media Resource
      Not available unless: You belong to Registered Students Only

    • Required Reading:

    • Victora CG et al. The Role of Conceptual Frameworks in Epidemiological Analysis: A Hierarchical Approach. International Journal of Epidemiology. Voll. 26. No.1 1997 File
      Not available unless: Your ID number contains 02
    • Guidance on using conceptual frameworks to guide statistical analysis in research with relevance to health equity
    • Vable AM et al. Do the health benefits of education vary by sociodemographic subgroup? Differential returns to education and implications for health inequities. Annals of Epidemiology Vol 28 pg. 759-766. 2018 File
      Not available unless: Your ID number contains 02
    • An applied paper from our lecturer for this week, illustrating analysis of effect modification. Try to not get bogged down in the details (especially not the tables), but rather appreciate the big picture relevance of this approach to understanding the nuanced reality of our world and how health is patterned.
    • Diez-Roux, AV. Bringing Context Back into Epidemiology: Variables and Fallacies in Multilevel Analysis. American Journal of Public Health. Vol. 88, No. 2. 1998 File
      Not available unless: Your ID number contains 02
    • A conceptual piece about the importance of consider multilevel analytic techniques
    • Lorch SA et al. Factors That Mediate Racial/Ethnic Disparities in US Fetal Death Rates. American Journal of Phublic Health. Vol 102, No.10. October 2012 File
      Not available unless: Your ID number contains 02
    • An applied paper using mediation to understand disparities. Focus on Intro, Methods, and Figure 1 (although the discussion does also add to the richness of the piece by interpreting the findings).

    • Optional Reading:

    • Coley SL. Does Neighborhood Risk Explain Racial Disparities in Low Birth Weight among Infants Born to Adolescent Mothers? J Pediatr Adolesc Gynecol. 2016 April ; 29(2): 122–129. File
      Not available unless: Your ID number contains 02
    • Merlo J et al. A brief conceptual tutorial of multilevel analysis in social epidemiology: linking the statistical concept of clustering to the idea of contextual phenomenon. J Epidemiol Community Health 2005;59:443–449 File
      Not available unless: Your ID number contains 02
    • Kawachi, I and Subramanian SV. Measuring and Modeling the Social and Geographic Context of Trauma: A Multilevel Modeling Approach. Journal of Traumatic Stress. Vol. 19, No. 2. 2006 File
      Not available unless: Your ID number contains 02

    • Resources:

    • Basic Analysis Issues for health disparities worksheet File

    • Assignment:

      Please post to the forum by 8:45am on the day of class

      1. Give an example of a research question for investigating racial/ethnic health disparities. In an analysis of this disparity, describe whether SES can act as [1] a confounder; [2] an effect modifier; [3] a mediator, and explain your answers. Discuss the interpretations/implications of the different approaches for including SES in an analysis of racial/ethnic disparities.

      2. Describe a potential effect modifier, mediator, or contextual variable (for definition of contextual variable, see Diez-Roux reading) for an association of interest to you and relevant to health disparities. For example, for investigating the association between education and hypertension, I might be interested in evaluating whether the association between years of education and hypertension is different for Black men than for White men. Describe how you would study whether this relationship exists.

      3. Respond to one other person's post on the forum with a comment or suggestion.


    • Slides for today File