1. Give an example of a research question for investigating racial/ethnic health disparities where: [1] SES is a confounder; [2] SES is an effect modifier; [3] SES is a mediator. Briefly discuss the interpretations/implications of each approach as it relates to understanding health disparities by race/ethnicity.
1. SES as confounder: Looking at how SES (income) affects men’s decision in choosing to get a vasectomy vs their partner’s getting their tubes tied. Female sterilization is more common than vasectomies despite vasectomies having less risks and it is a much quicker outpatient procedure.
2. SES as an effect modifier: What is the impact of race/ethnicity on choosing vasectomies. Do men with a higher SES opt for vasectomies or perhaps there is no difference in vasectomy rates due to income.
3. SES as a mediator: It appears that Spanish speaking men are less likely to opt for a vasectomies. Would having an educational tool in Spanish (that clinicians can use) about the benefits of vasectomies improve the rate of vasectomies? Using language as a proxy for SES
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.
I am interested in studying how place of birth may affect Latinas’ choice of contraception specifically sterilization. How does a Latina born in Latin America who came to the USA as an adult differ in her decision-making vs a first generation and second generation Latina? I could look at acculturation, SES, education, and other factors that may apply to this question.