Please post to the forum by 1pm on the day of class
1. What are 3 different ways to account for SES in an analytic model when investigating racial/ethnic health disparities? (describe a fourth for extra bonus points!). Briefly discuss the interpretations/implications of each approach as it relates to the interest in understand health disparities by race/ethnicity.
Mediation analysis allows you to understand the effect that a mediator (factor) has on the measure of association between the exposure and outcome. You can do sequential modeling to identify effect of each variable that you add into the model. Can use generalized estimating equations (GEE) with log link functions to estimate risk ratios for race and outcome of interest. Can perform series of binomial hierarchical generalized linear models with an initial model that includes racial identification, to identify racial differences in the outcome of interest.
2. Describe a potential effect modifier, mediator, or contextual variable (for definition of contextual variable, see first page of option Merlo reading) for an association of interest to you and relevant to health disparities. For example, for investigating the association between SES and maternal mortality, I might be interested in the contextual variable of exposure to violence in the neighborhood. Describe how you would study whether this relationship exists.
See attached image of a mediation analysis looking at racial/ethnic disparities in prostate cancer which demonstrates that stage of diagnosis has the greatest effect on disparities observed in survival (Scarlett Gomez and colleagues, 2017)
