Evidence map›Paper›PMID 34124937›Full record

ReviewEnvironmental health perspectives2021

Confounding by Socioeconomic Status in Epidemiological Studies of Air Pollution and Health: Challenges and Opportunities.

Anjum Hajat, Richard F MacLehose, Anna Rosofsky, Katherine D Walker, Jane E Clougherty

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Environmental health perspectives, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 65 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
65citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

65 citing papers in PubMed, 6 syntheses or guidelines pooled it.

  1. Pooled it
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  6. Pooled it
  7. A Geospatial Linkage Analysis of Environmental Exposures, Socioeconomic Profile and Health Outcomes Among Women of Reproductive Age in Victoria, Australia.Health promotion journal of Australia : official journal of Australian Association of Health Promotion Professionals · 2026
    Article
  8. Article
  9. Article
  10. Disparity in non-communicable disease burden attributable to ambient PMJournal of exposure science & environmental epidemiology · 2026
    Article
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  15. Review
  16. Article
  17. Review
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  20. Observational

5 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Anjum HajatDepartment of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA.
Richard F MacLehoseDivision of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
Anna RosofskyHealth Effects Institute, Boston, Massachusetts, USA.
Katherine D WalkerHealth Effects Institute, Boston, Massachusetts, USA.
Jane E CloughertyDepartment of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA.

Funding

XENOBIOTIC BIOTRANSFORMATION AND DISPOSITIONP30ES007033 · NIEHS · UNIVERSITY OF WASHINGTON · PI Sheela Sathyanarayana · 1995 to 2026
$42.5M
Interaction of Air Pollution and Psychosocial Stress on Cardiovascular Disease.R00ES023498 · NIEHS · UNIVERSITY OF WASHINGTON · PI HAJAT, ANJUM · 2016 to 2018
$747k
NIEHS NIH HHS P30 ES007033NIEHS NIH HHS R00 ES023498
6 · The paper itself

Abstract

backgroundDespite a vast air pollution epidemiology literature to date and the recognition that lower-socioeconomic status (SES) populations are often disproportionately exposed to pollution, there is little research identifying optimal means of adjusting for confounding by SES in air pollution epidemiology, nor is there a strong understanding of biases that may result from improper adjustment.

objectiveWe aim to provide a conceptualization of SES and a review of approaches to its measurement in the U.S. context and discuss pathways by which SES may influence health and confound effects of air pollution. We explore bias related to measurement and operationalization and identify statistical approaches to reduce bias and confounding. DISCUSSION: Drawing on the social epidemiology, health geography, and economic literatures, we describe how SES, a multifaceted construct operating through myriad pathways, may be conceptualized and operationalized in air pollution epidemiology studies. SES varies across individuals within the contexts of place, time, and culture. Although no single variable or index can fully capture SES, many studies rely on only a single measure. We recommend examining multiple facets of SES appropriate to the study design. Furthermore, investigators should carefully consider the multiple mechanisms by which SES might be operating to identify those SES indicators that may be most appropriate for a given context or study design and assess the impact of improper adjustment on air pollution effect estimates. Last, exploring model contraction and expansion methods may enrich adjustment, whereas statistical approaches, such as quantitative bias analysis, may be used to evaluate residual confounding. https://doi.org/10.1289/EHP7980.

Indexed as

Air PollutantsAir PollutionEnvironmental ExposureEpidemiologic StudiesHumansSocial ClassAir Pollutants

Identifiers

PMID34124937
PMCPMC8202292

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.