ArticleAnnals of epidemiology2019
How do we assess a racial disparity in health? Distribution, interaction, and interpretation in epidemiological studies.
Article in Annals of epidemiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 168 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
168 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Hazardous Environmental Pollutants and Cancer Disparities: A Systematic Review on the Consideration of Race and Ethnicity in Environmental Epidemiology Research.Current environmental health reports · 2025Pooled it
- "We adjusted for race": now what? A systematic review of utilization and reporting of race in American Journal of Epidemiology and Epidemiology, 2020-2021.Epidemiologic reviews · 2023Pooled it
- Maladaptive coping strategies mediate the relationship between perceived differential treatment and sleep health among women.Journal of behavioral medicine · 2026Article
- Streetview greenspace types and dementia risk in older adults: the Multi-Ethnic Study of Atherosclerosis.American journal of epidemiology · 2026Article
- Association of Intimate Partner Violence With Substance Use Among Adults in Same-Sex and Opposite-Sex Partnerships.Journal of interpersonal violence · 2026Article
- Evaluating the mediating role of gestational phthalate and replacement biomarkers in the associations between race/ethnicity and birthweight.Environmental epidemiology (Philadelphia, Pa.) · 2026Article
- The Association Between Structural Disadvantage and Adverse Birth Outcomes: Analyzing Preterm Birth and Low Birth Weight Using the Structural Racism Effect Index.Journal of racial and ethnic health disparities · 2026Article
- The association of adverse childhood experiences and life course relationship quality with late-life cognitive health: Moderation by race/ethnicity and gender.Journal of Alzheimer's disease : JAD · 2026Article
- The Enduring Impact of Cohort Differences in Explaining Population Health.Paediatric and perinatal epidemiology · 2026Article
- Mild Traumatic Brain Injury and Subsequent Musculoskeletal Injury in US Service Members.JAMA network open · 2026Article
- The use of race and ethnicity in air pollution epidemiology and methodological recommendations: A scoping review focusing on California.Environmental epidemiology (Philadelphia, Pa.) · 2026Review
- Anticipating Racism is Associated with Poorer Sleep Among Adults Racialized as Black.Journal of racial and ethnic health disparities · 2026Article
- Multiple dimensions of sleep in relation to cognition: A nationally representative study of Asian, Black, Latine, and White US adults aged 40 years and older.Sleep health · 2026Article
- Straining Under Contradiction? Contradictory Class Locations and Job Strain in the United States.International journal of social determinants of health and health services · 2026Article
- Relations of left ventricular mass and hypertrophy to cognitive function in urban dwelling African American and White adults.Neuropsychology · 2026Article
- Changes in Frequency and Health of Live Births Following State Abortion Bans.American journal of public health · 2026Article
- Perceived control, brain health, and cognitive reserve: longitudinal resilience mechanisms in Black, White, and Hispanic older adults.The journals of gerontology. Series B, Psychological sciences and social sciences · 2026Article
- State minimum wage laws and state-level rates of new HIV diagnoses among Black, Latine, and White US women and men, 2010-2019.Journal of epidemiology and community health · 2026Article
- Sleep-disordered breathing subtypes and future diet quality in the Multi-Ethnic Study of Atherosclerosis.Sleep health · 2025Article
- Measures of Structural Racism and Black-White Disparity in Stillbirth Rates in New York City, 2009-2018: A Population-Based Cross-Sectional Study.BJOG : an international journal of obstetrics and gynaecology · 2025Article
108 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
Identifying the exposures or interventions that exacerbate or ameliorate racial health disparities is one of the fundamental goals of social epidemiology. Introducing an interaction term between race and an exposure into a statistical model is commonly used in the epidemiologic literature to assess racial health disparities and the potential viability of a targeted health intervention. However, researchers may attribute too much authority to the interaction term and inadvertently ignore other salient information regarding the health disparity. In this article, we highlight empirical examples from the literature demonstrating limitations of overreliance on interaction terms in health disparities research; we further suggest approaches for moving beyond interaction terms when assessing these disparities. We promote a comprehensive framework of three guiding questions for disparity investigation, suggesting examination of the group-specific differences in (1) outcome prevalence, (2) exposure prevalence, and (3) effect size. Our framework allows for better assessment of meaningful differences in population health and the resulting implications for interventions, demonstrating that interaction terms alone do not provide sufficient means for determining how disparities arise. The widespread adoption of this more comprehensive approach has the potential to dramatically enhance understanding of the patterning of health and disease and the drivers of health disparities.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.