Part 1:
1. Choose a paper describing the development or validation of a measure of relevance in health disparities research (please give the full citation and/or upload the paper if that's possible).
Kreiger et al (Soc Sci Med. 2005 Oct;61(7):1576-96. doi: 10.1016/j.socscimed.2005.03.006.) developed a validated measure of racial discrimination.
2. What was the definition of the construct?
They did not explicitly define how they were conceptualizing racial discrimination, outside of describing that they intentionally focused on reported experiences and did not use the phrase “perceived discrimination,” noting that people experience discrimination but do not report it.
3. How did the authors provide evidence on the validity of the measure? Could you think of additional approaches to validating the measure?
They calculated Cronbach’s alpha for their newly developed survey, which was high, and also selected a “key informant” for each participant in which they asked this person if the participant had ever experienced racial discrimination. They finally demonstrated that there was a positive association between psychological distress and the scale score, as well as with ever having smoked cigarettes and the scale score. It is not clear to me exactly where they developed their survey items from, and I think if they had used critical race theorists in their development it could have bolstered their argument of validity.
4. How did the authors provide evidence on the reliability of the measure? Could you think of additional approaches to evaluating the reliability of the measure?
They repeated the test for participants and looked at correlation of the results between the two attempts, and found correlations of 0.69 and higher, but noted that for single item measures this was much lower. This sample only included people in the Boston area, so broadening their sample to different geographic regions could have improved reliability.
5. Describe the implications of a lack of measurement validity or reliability for future research applications.
Measuring experiences of discrimination has important implications for being able to accurately quantify this construct both for associative studies and intervention development. If this was not adequately (lacking in validity or reliability) measured then the results from following studies using this metric would be in question. I do research in abortion attitudes, and there is currently not a validated measure for this (although one is actively being developed), which means all prior studies have been using different metrics with unclear methodology into their development. This makes comparison virtually impossible across time or populations. So the importance of discrimination being measured adequately is also important for the field to come to a consensus on measurement so that we can build a body of knowledge that is trying to understand the same thing.
Part 2:
1. Find a paper describing a health disparity (please give the full citation or, even better, upload the paper so everyone else can look at it too)
Chambers et al (J Urban Health. 2019 Apr;96(2):159-170. doi: 10.1007/s11524-018-0272-4) examined the association between structural racism and preterm birth and infant mortality in California.
2. Summarize the construct and measurement of the dimension of disparity (e.g., racial inequalities?, SES inequalities?) and the outcome measured (e.g., self-rated health).
They measured structural racism using the index of concentration at the extremes (ICE). The defined structural racism as “involving systematic laws and processes used to differentiate access to services, goods, and opportunities in society by racial groups.” ICE measures spatial social polarizations of both deprived and privileged SES groups, which was later adapted to include a measure of racial disparities.
3. What is the evidence for the validity and reliability of the measures?
This paper does not get into how the measure was developed, and its validity and reliability, but they reference the paper that developed it.
4. What is the reference category used for the disparity measure (ie, who is the comparison group)? Why does this reference category make sense (or not) for this research question?
They calculated ICE measures for race, income, and race+income separately. For race the comparison group was non-Hispanic whites, and for SES the comparison group was people who made more than $100,000 annually. The reference groups do make sense for this research question since they are trying to answer specifically how ICE as it relates to the most privileged and disadvantaged groups is associated with pre-term birth.
5. How is the disparity quantified or measured? Is this an absolute or relative measure or are both provided? Describe which type of measure you would prefer for this research area, or, if both, why.
They provided both relative and absolute measures of the difference in pre-term birth between the most privileged groups. I prefer both for this type of research area because I think they are getting at slightly separate things. Even if the absolute difference was low, the relative difference is of high importance because this captures more accurately the impact of structural racism on women of color compared to white women. The absolute measure is also important because it could generate important measures for public health interventions.