Racial and ethnic disparities in chronic health conditions among women with a history of gestational diabetes mellitus

Bazargan‐Hejazi, Shahrzad; Ruiz, Maria Camila; Ullah, Shakir; Siddiqui, Gazala; Bangash, Maria; Khan, Shahbaz Ali; Shang, Wendy; Moradi, Parissa; Shaheen, Magda

doi:10.34172/hpp.2021.08

Cited by 4 publications

(2 citation statements)

References 38 publications

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“…A legacy of racial discrimination in medical research and the health care system has been linked to a low level of trust in medical research and medical care among African Americans [ 27 ]. This mistrust is associated with perceived discrimination, and addressing this perception is one of the key elements of addressing racial health disparities [ 28 ]. Clinical researchers should evaluate every preventive and treatment recommendation as a potential source of structural racism.…”

Section: Discussionmentioning

confidence: 99%

Mediation Analysis of Racial Disparity for Infant Mortality Using Bayesian Estimation of Potential Outcomes

Thompson

2024

JCM

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Background/Objectives: While the overall rate of infant mortality in the United States has been decreasing over decades, the racial disparity, defined as the difference between races, has increased. Even though a person’s race cannot change, it may be possible to identify factors that mediate or cause this racial disparity. Evaluating the factors that mediate or cause racial disparity is imperative because current clinical recommendations could be based on preventative modalities that are more effective for white women and their children. Methods: A Bayesian approach modeled the data from the full United States National Natality Database for the years 2016 to 2018. The binomial rate parameters for each combination of race and mediators provided the potential outcomes. Estimating the mediation outcomes, including total effect, controlled direct effect, mediated effect, and proportion mediated used common counterfactual definitions for these probabilities. Results: Maternal smoking, low birthweight, and teenage maternity interacted in causing racial disparity for infant mortality. The proportion of racial disparity attributable to low birthweight was approximately 0.73, with only small variations attributable to maternal smoking and teenage maternity. Conclusions: The novel approach facilitated modeling of multiple mediators. Low birthweight caused racial disparity for infant mortality. The model can be extended to evaluate additional mediational factors with the objective of identifying the preventable causes.

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Section: Discussionmentioning

confidence: 99%

Mediation Analysis of Racial Disparity for Infant Mortality Using Bayesian Estimation of Potential Outcomes

Thompson

2024

JCM

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“…A legacy of racial discrimination in medical research and the health care system has been linked to a low level of trust in medical research and medical care among African Americans [19]. This mistrust is associated with perceived discrimination and addressing this perception is one of the key elements of addressing racial health disparities [20]. To address this perception, direct Bayesian estimation of the PA of mediators toward racial disparity could be used to ensure racial fairness.…”

Section: Discussionmentioning

confidence: 99%

Bayesian estimation of potential outcomes for mediation analysis of racial disparity for infant mortality

Thompson

2023

Preprint

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Background: There is a need for novel methods to determine preventable causes of racial health disparities. This need has been met with the development of improved methods for mediation modeling. Current mediational analysis methods call for an evaluation of statistical interaction or effect modification between the investigated cause and mediator. For racial disparity, this approach facilitates the estimation of racially specific risks for infant mortality. However, current methods for evaluating multiple interacting mediators are inadequate. The first objective of the study was to compare Bayesian estimation of potential outcomes to other approaches to mediation analysis that included interaction. The second objective was to evaluate three potentially interacting mediators of racial disparity for infant mortality by modeling the large dataset from the National Natality Database using Bayesian estimation of potential outcomes. Methods: A random sample of observations from the 2003 National Natality Database was used to compare the currently promoted methods for mediation modeling. Racial disparity was modeled as a separate function for each of three potential mediators, (i) maternal smoking, (ii) low birth weight and (iii) teenage maternity. As a second objective, direct Bayesian estimation of potential outcomes modeled infant mortality as function of the interactions among the three mediators and race using the full National Natality Database for the years 2016 to 2018. Results: The counterfactual model was inaccurate in estimating the proportion of racial disparity that was attributable to either maternal smoking or teenage maternity. The counterfactual approach did not accurately estimate the probabilities defined by counterfactual definitions. The error was a result of modeling the excess relative risk instead of the risk probabilities. Bayesian approaches did estimate the probabilities of the counterfactual definitions. Results showed that 73% of the racial disparity for infant mortality was attributed to infants born with low birth weight. Conclusions. Bayesian estimation of potential outcomes could evaluate whether proposed public health programs would affect races differently and decisions could include consideration of the causal effect the program may have on racial disparity. The large contribution of low birth weight to racial disparity for infant mortality should be further investigated to identify preventable factors for low birth weight.

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Gestational Diabetes and Subsequent Metabolic Dysfunction: An National Health and Nutrition Examination Survey Analysis (2011–2018)

Schultz,

Ha,

Williams

2024

Metabolic Syndrome and Related Disorders

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Racial and ethnic disparities in chronic health conditions among women with a history of gestational diabetes mellitus

Cited by 4 publications

References 38 publications

Mediation Analysis of Racial Disparity for Infant Mortality Using Bayesian Estimation of Potential Outcomes

Mediation Analysis of Racial Disparity for Infant Mortality Using Bayesian Estimation of Potential Outcomes

Bayesian estimation of potential outcomes for mediation analysis of racial disparity for infant mortality

Gestational Diabetes and Subsequent Metabolic Dysfunction: An National Health and Nutrition Examination Survey Analysis (2011–2018)

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