ArticleInternational journal of epidemiology2023
Systematic exclusion at study commencement masks earlier menopause for Black women in the Study of Women's Health Across the Nation (SWAN).
Article in International journal of epidemiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 9 citations in OpenAlex.
- Menopause and neurological disorders: a roadmap for research.Nature reviews. Neurology · 2026Review
- Associations of Sociodemographic and Neighborhood Vulnerability With Cardiovascular Health in Midlife Women in the United States.Circulation. Population health and outcomes · 2026Article
- Factors correlated with financial hardship among cancer patients during the COVID-19 pandemic.PloS one · 2026Article
- Methodological innovations in studying marginalized populations in research on neurodegeneration and ageing.Frontiers in aging neuroscience · 2026Review
- Menopause care for diverse communities: a qualitative study of GP clinician experiences.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Article
- Maintaining Balance: Examining Mental Wellness in Black Women During the Menopausal Transition.Journal of racial and ethnic health disparities · 2025Article
- Menopause and its effects on autonomic regulation of blood pressure: Insights and perspectives.Autonomic neuroscience : basic & clinical · 2025Review
- Impact of 1940s exposure to redlining on mortality and self-rated health later in life among older adults.medRxiv : the preprint server for health sciences · 2025Article
- Preservation of Vascular Endothelial Function in Late-Onset Postmenopausal Women.Circulation research · 2025Article
- Association of social determinants of health and age at menopause: NHANES 1999-2018 observational study.Human reproduction open · 2025Article
- Beyond Bleeding: An Analysis of Presenting Symptoms Among Black Patients with Endometrial Cancer.Health equity · 2025Article
- Does everyday discrimination account for the increased risk of vasomotor symptoms in Black women?: the Study of Women's Health Across the Nation (SWAN).Menopause (New York, N.Y.) · 2024Article
- The relation of heavy or prolonged bleeding during the menopause transition to risk of hysterectomy.Women's health (London, England)Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
backgroundShorter average lifespans for minoritized populations are hypothesized to stem from 'weathering' or accelerated health declines among minoritized individuals due to systemic marginalization. However, evidence is mixed on whether racial/ethnic differences exist in reproductive ageing, potentially due to selection biases in cohort studies that may systematically exclude 'weathered' participants. This study examines racial/ethnic disparities in the age of menopause after accounting for differential selection 'into' (left truncation) and 'out of' (right censoring) a cohort of midlife women.
methodsUsing data from the Study of Women's Health Across the Nation (SWAN) cross-sectional screener (N = 15 695) and accompanying ∼20-year longitudinal cohort (N = 3302) (1995-2016), we adjusted for potential selection bias using inverse probability weighting (left truncation) to account for socio-demographic/health differences between the screening and cohort study, and multiple imputation (right censoring) to estimate racial/ethnic differences in age at menopause (natural and surgical).
resultsUnadjusted for selection, no Black/White differences in menopausal timing [hazard ratio (HR)=0.98 (0.86, 1.11)] were observed. After adjustment, Black women had an earlier natural [HR = 1.13 (1.00, 1.26)] and surgical [HR= 3.21 (2.80, 3.62)] menopause than White women with natural menopause-corresponding to a 1.2-year Black/White difference in menopause timing overall.
conclusionsFailure to account for multiple forms of selection bias masked racial/ethnic disparities in the timing of menopause in SWAN. Results suggest that there may be racial differences in age at menopause and that selection particularly affected the estimated menopausal age for women who experienced earlier menopause. Cohorts should consider incorporating methods to account for all selection biases, including left truncation, as they impact our understanding of health in 'weathered' populations.
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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.