ArticleEpidemiology (Cambridge, Mass.)2021
Meaningful Causal Decompositions in Health Equity Research: Definition, Identification, and Estimation Through a Weighting Framework.
Article in Epidemiology (Cambridge, Mass.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 56 papers, 1 of them a synthesis 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.
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Who cites it
56 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Ethnoracial disparities in breast cancer treatment time and survival: a systematic review with a DAG-based causal model.Epidemiologic reviews · 2025Pooled it
- Causal decomposition framework for quantifying intervenable cancer health disparities.Biometrics · 2026Article
- Racial and Ethnic Differences in Healthcare Experiences for Veterans Receiving Care from VA and Non-VA Providers.Journal of general internal medicine · 2026Observational
- The use of race and ethnicity in air pollution epidemiology and methodological recommendations: A scoping review focusing on California.Environmental epidemiology (Philadelphia, Pa.) · 2026Review
- Applying the Target Study Conceptual Model to Measure Racial and Ethnic Disparities in Hypertension Treatment Intensification.Epidemiology (Cambridge, Mass.) · 2026Article
- A Framework for Thinking About the Potential Public Health Impact of Epidemiologic Research.Epidemiology (Cambridge, Mass.) · 2026Article
- Causal Inference in Health Disparities Research.Annual review of public health · 2026Review
- Straining Under Contradiction? Contradictory Class Locations and Job Strain in the United States.International journal of social determinants of health and health services · 2026Article
- Covariate adjustment in LGBTQ+ health disparities research: aligning methods with assumptions.American journal of epidemiology · 2026Article
- Challenges in estimating effects of hypothetical interventions on resources patterned by structural racism: an example in a rural North Carolina Medicaid population.American journal of epidemiology · 2026Article
- Exacerbation of racial disparities in COVID-19 outcomes by Alzheimer's disease and related dementias among nursing home residents.American journal of epidemiology · 2026Article
- Matching with Multiple Criteria and Its Application to Health Disparities Research.Observational studies · 2026Article
- Do men and women define health differently? A cross-national study of gender differences in self-rated health.Frontiers in public health · 2026Article
- Decomposition of longitudinal disparities: an application to the fetal growth-singletons study.Biostatistics (Oxford, England) · 2025Article
- A Research Agenda to Mitigate Racial and Ethnic Disparities in U.S. Critical Care Medicine: An Official American Thoracic Society Research Statement.American journal of respiratory and critical care medicine · 2025Article
- Three-Way Decomposition for Applied Health Equity Research: A Practical Tutorial to Understand and Address Inequalities.Prevention science : the official journal of the Society for Prevention Research · 2025Article
- Payments to Physician Practices and Incentives to Serve Different Racial and Ethnic Groups.JAMA health forum · 2025Observational
- Article
- Developing inclusive, antiracist approaches to public health research: Guidelines for action.Journal of public health research · 2025Article
- Competing classes confront competing risks: unraveling mortality inequities with parametric g-computation.American journal of epidemiology · 2025Article
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
1 author.
Funding
Abstract
Causal decomposition analyses can help build the evidence base for interventions that address health disparities (inequities). They ask how disparities in outcomes may change under hypothetical intervention. Through study design and assumptions, they can rule out alternate explanations such as confounding, selection bias, and measurement error, thereby identifying potential targets for intervention. Unfortunately, the literature on causal decomposition analysis and related methods have largely ignored equity concerns that actual interventionists would respect, limiting their relevance and practical value. This article addresses these concerns by explicitly considering what covariates the outcome disparity and hypothetical intervention adjust for (so-called allowable covariates) and the equity value judgments these choices convey, drawing from the bioethics, biostatistics, epidemiology, and health services research literatures. From this discussion, we generalize decomposition estimands and formulae to incorporate allowable covariate sets (and thereby reflect equity choices) while still allowing for adjustment of non-allowable covariates needed to satisfy causal assumptions. For these general formulae, we provide weighting-based estimators based on adaptations of ratio-of-mediator-probability and inverse-odds-ratio weighting. We discuss when these estimators reduce to already used estimators under certain equity value judgments, and a novel adaptation under other judgments.
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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.