What are 3 different ways to account for SES in a analytic models when investigating racial/ethnic health disparities? Briefly discuss the interpretations/implications of each approach as it relates to understanding health disparities by race/ethnicity.
1) For confounding: If we want to evaluate the association between race / ethnic origin and a given health outcome, we should take into account SES factors that could confuse this relationship, such as income and education (Depends on the type of SES measurement).
2) For mediation: If we want to identify the direct and indirect effects of an exposure, as in the Lorch article, we can use the framework of Baron and Kenny and study the association of race / ethnicity with the risk of fetal death (your health result of interest) and race / ethnicity and other mediating factors.
3) For the interaction, in which you want to see the individual and joint effects of an exposure, you can create terms of interaction between race / ethnicity and other SES, to see if your interaction is associated with the result of health interest. So the question would be how does the race / ethnicity association and the result of interest change, with the other SES variable included?
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.
Currently, electronic cigarettes are the most commonly used nicotine or tobacco product. Several studies show that adolescent electronic cigarette users are likely to switch to the use of fuel or dual-use tobacco, which increases the risk of nicotine dependence. It is essential that we better understand the risk factors and health effects associated with the use of electronic cigarettes, including the transition to combustible tobacco products and the differential risk for users who only use electronic cigarettes and dual users. The research suggests that access to the electronic cigarette is an important contextual variable. We could define the spatial accessibility for tobacco retailers (density of tobacco retailers, nearest tobacco retailer and average distance to the nearest 5 tobacco retailers) and compare between various neighborhoods potentially to study.