ArticlePloS one2020
Non-response in a national health survey in Germany: An intersectionality-informed multilevel analysis of individual heterogeneity and discriminatory accuracy.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Understanding determinants of patient-reported outcome measure non-response among transgender and gender diverse individuals: an intersectional multilevel analysis of sociodemographic and structural vulnerabilities.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026Observational
- What can we learn from an intersectionality-informed description of study participants? Results from the German National Cohort.International journal for equity in health · 2025Article
- Article
- Health inequalities at the intersection of multiple social determinants among under five children residing Nairobi urban slums: An application of multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA).PLOS global public health · 2024Article
- Article
- Non-response bias in the analysis of the association between mental health and the urban environment: a cross-sectional study in Brussels, Belgium.Archives of public health = Archives belges de sante publique · 2023Article
- Investigating people's attitudes towards participating in longitudinal health research: an intersectionality-informed perspective.International journal for equity in health · 2023Article
- Intersectionality-Informed Sex/Gender-Sensitivity in Public Health Monitoring and Reporting (PHMR): A Case Study Assessing Stratification on an "Intersectional Gender-Score".International journal of environmental research and public health · 2023Article
- The effects of social determinants on children's health outcomes in Bangladesh slums through an intersectionality lens: An application of multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA).PLOS global public health · 2023Article
- CART-analysis embedded in social theory: A case study comparing quantitative data analysis strategies for intersectionality-based public health monitoring within and beyond the binaries.SSM - population health · 2021Article
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8 authors.
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Abstract
backgroundDimensions of social location such as socioeconomic position or sex/gender are often associated with low response rates in epidemiological studies. We applied an intersectionality-informed approach to analyze non-response among population strata defined by combinations of multiple dimensions of social location and subjective health in a health survey in Germany.
methodsWe used data from the cross-sectional sample of the German Health Interview and Examination Survey for Adults (DEGS1) conducted between 2008 and 2011. Information about non-responders was available from a mailed non-responder questionnaire. Intersectional strata were constructed by combining all categories of age, sex/gender, marital status, and level of education in scenario 1. Subjective health was additionally used to construct intersectional strata in scenario 2. We applied multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) to calculate measures of discriminatory accuracy, proportions of non-responders among intersectional strata, as well as stratum-specific total interaction effects (intersectional effects). Markov chain Monte Carlo methods were used to estimate multilevel logistic regression models.
resultsData was available for 6,534 individuals of whom 36% were non-responders. In scenario 2, we found weak discriminatory accuracy (variance partition coefficient = 3.6%) of intersectional strata, while predicted proportions of non-response ranged from 20.6% (95% credible interval (CI) 17.0%-24.9%) to 57.5% (95% CI 48.8%-66.5%) among intersectional strata. No evidence for intersectional effects was found. These results did not differ substantially between scenarios 1 and 2.
conclusionsMAIHDA revealed that proportions of non-response varied widely between intersectional strata. However, poor discriminatory accuracy of intersectional strata and no evidence for intersectional effects indicate that there is no justification to exclusively target specific intersectional strata in order to increase response, but that a combination of targeted and population-based measures might be appropriate to achieve more equal representation.
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