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Review
. 2024 Mar 1:14:04046.
doi: 10.7189/jogh.14.04046.

Reporting of equity in observational epidemiology: A methodological review

Omar Dewidar  1   2 , Ali Al-Zubaidi  2   3 , Mostafa Bondok  2   4 , Leenah Abdelrazeq  2 , Jimmy Huang  2 , Alyssa Jearvis  2 , Lucy C Barker  5   6 , Nour Elmestekawy  2   7 , Elizabeth Goghomu  2 , Tamara Rader  8 , Janice Tufte  9 , Regina Greer-Smith  10 , Hugh S Waddington  11   12 , Stuart G Nicholls  13   14 , Julian Little  15 , Billie-Jo Hardy  16   17 , Tanya Horsley  18 , Taryn Young  19 , Luis Gabriel Cuervo  20   21 , Melissa K Sharp  22 , Catherine Chamberlain  23   24 , Beverley Shea  13   15 , Peter Craig  25 , Daeria O Lawson  26 , Anita Rizvi  27 , Charles S Wiysonge  28 , Tamara Kredo  28   19 , Damian Francis  29 , Elizabeth Kristjansson  13   15 , Zulfiqar Bhutta  30   31 , Alba Antequera  32 , G J Melendez-Torres  33 , Tomas Pantoja  34 , Xiaoqin Wang  35 , Janet Jull  36 , Janet Hatcher Roberts  37 , Sarah Funnell  38 , Howard White  39 , Alison Krentel  2 , Michael Johnson Mahande  40 , Jacqueline Ramke  41 , George Wells  15   42 , Jennifer Petkovic  2 , Kevin Pottie  43   44 , Loveline Niba  45   46 , Cindy Feng  15 , Miriam N Nguliefem  15 , Peter Tugwell  2   13   47 , Lawrence Mbuagbaw  26 , Vivian Welch  2   15
Affiliations
Review

Reporting of equity in observational epidemiology: A methodological review

Omar Dewidar et al. J Glob Health. .

Abstract

Background: Observational studies can inform how we understand and address persisting health inequities through the collection, reporting and analysis of health equity factors. However, the extent to which the analysis and reporting of equity-relevant aspects in observational research are generally unknown. Thus, we aimed to systematically evaluate how equity-relevant observational studies reported equity considerations in the study design and analyses.

Methods: We searched MEDLINE for health equity-relevant observational studies from January 2020 to March 2022, resulting in 16 828 articles. We randomly selected 320 studies, ensuring a balance in focus on populations experiencing inequities, country income settings, and coronavirus disease 2019 (COVID-19) topic. We extracted information on study design and analysis methods.

Results: The bulk of the studies were conducted in North America (n = 95, 30%), followed by Europe and Central Asia (n = 55, 17%). Half of the studies (n = 171, 53%) addressed general health and well-being, while 49 (15%) focused on mental health conditions. Two-thirds of the studies (n = 220, 69%) were cross-sectional. Eight (3%) engaged with populations experiencing inequities, while 22 (29%) adapted recruitment methods to reach these populations. Further, 67 studies (21%) examined interaction effects primarily related to race or ethnicity (48%). Two-thirds of the studies (72%) adjusted for characteristics associated with inequities, and 18 studies (6%) used flow diagrams to depict how populations experiencing inequities progressed throughout the studies.

Conclusions: Despite over 80% of the equity-focused observational studies providing a rationale for a focus on health equity, reporting of study design features relevant to health equity ranged from 0-95%, with over half of the items reported by less than one-quarter of studies. This methodological study is a baseline assessment to inform the development of an equity-focussed reporting guideline for observational studies as an extension of the well-known Strengthening Reporting of Observational Studies in Epidemiology (STROBE) guideline.

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Conflict of interest statement

Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and declare the following activities and relationships: LGC is employed by the Pan American Health Organization (PAHO/WHO). The ideas expressed in this manuscript are the authors’ own and do not necessarily reflect the decisions and policies of PAHO/WHO. The remaining authors have no conflicts to declare.

Figures

Figure 1
Figure 1
Study flow diagram.
Figure 2
Figure 2
The reporting of equity in equity-relevant observational studies.
Figure 3
Figure 3
Distribution of analyses in 320 equity relevant-observational studies across PROGRESS-Plus characteristics.
See this image and copyright information in PMC

References

    1. Wilson S, Breen A, Dupré L. Research and Reconciliation Unsettling Ways of Knowing through Indigenous Relationships. Toronto: Canadian Scholars; 2019.
    1. World Health Organization. Health inequities and their causes. 2018. Available: https://www.who.int/news-room/facts-in-pictures/detail/health-inequities.... Accessed: 25 May 2022.
    1. Gee GC, Ford CL.STRUCTURAL RACISM AND HEALTH INEQUITIES: Old Issues, New Directions. Du Bois Rev. 2011;8:115–32. 10.1017/S1742058X11000130 - DOI - PMC - PubMed
    1. Whitehead M.The concepts and principles of equity and health. Int J Health Serv. 1992;22:429–45. 10.2190/986L-LHQ6-2VTE-YRRN - DOI - PubMed
    1. Government of Canada. Gender-based analysis plus (GBA+). 2022. Available: https://www.canada.ca/en/immigration-refugees-citizenship/corporate/publ.... Accessed: 25 May 2022.