Conceptualization, Operationalization, and Utilization of Race and Ethnicity in Major Epidemiology Journals, 1995-2018: A Systematic Review

Abstract

Despite repeated calls by scholars to critically engage with the concepts of race and ethnicity in US epidemiologic research, the incorporation of these social constructs in scholarship may be suboptimal. This study characterizes the conceptualization, operationalization, and utilization of race and ethnicity in US research published in leading journals whose publications shape discourse and norms around race, ethnicity, and health within the field of epidemiology. We systematically reviewed randomly selected articles from prominent epidemiology journals across 5 periods: 1995-1999, 2000-2004, 2005-2009, 2010-2014, and 2015-2018. All original human-subjects research conducted in the United States was eligible for review. Information on definitions, measurement, coding, and use in analysis was extracted. We reviewed 1,050 articles, including 414 (39%) in our analyses. Four studies explicitly defined race and/or ethnicity. Authors rarely made clear delineations between race and ethnicity, often adopting an ethnoracial construct. In the majority of studies across time periods, authors did not state how race and/or ethnicity was measured. Top coding schemes included "Black, White" (race), "Hispanic, non-Hispanic" (ethnicity), and "Black, White, Hispanic" (ethnoracial). Most often, race and ethnicity were deemed "not of interest" in analyses (e.g., control variables). Broadly, disciplinary practices have remained largely the same between 1995 and 2018 and are in need of improvement.

Keywords: ethnicity; health equity; race; scientific communication; systematic reviews.

Figure 1

Outline and conduct of a study on the use of race and ethnicity in research published in 5 leading general epidemiology journals, 1995–2018. A) Study sampling and inclusion strategy. The total population of articles included all articles published in the 5 identified journals between January 1, 1995, and December 31, 2018. In total, 18,905 articles were identified; this included articles that did not meet study eligibility criteria (i.e., US-based, original human subjects research). B) Denominators used in the study, by research question. For question 3, coding schemes were grouped on the basis of question 1 results (i.e., race, ethnicity, or ethnoracial data). Studies with racial coding schemes included racial data and may have included ethnicity data, but did not combine the two into an ethnoracial construct. Similarly, studies with ethnic coding schemes included ethnic data and may have included racial data, but kept them as distinct constructs. Studies denoted as “ethnoracial” combined or conflated racial and ethnic data. Denominators for question 4 were identical to those for question 2 and are therefore not shown.

Figure 2

Proportion of epidemiologic studies that included information on the study population’s race and/or ethnicity over time, 1995–2018. Across all strata, 414 articles met the inclusion criteria. Of those, 313 included at least racial data (irrespective of including ethnicity data) and 209 included at least ethnicity data (irrespective of racial data).