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 five periods: 1995-99, 2000-04, 2005-09, 2010-14, 2015-18. All original human-subjects research conducted in the US was eligible for review. Information on definitions, measurement, coding, and use in analysis was extracted. We reviewed 1050 articles, including 414 (39%) in analyses. Four studies explicitly defined race and/or ethnicity. Authors rarely made clear delineations between race and ethnicity, often adopting an ethno-racial 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” (ethno-racial). Most often, race and ethnicity were deemed “not of interest” in analyses (e.g., control variable). Broadly, disciplinary practices have remained largely the same between 1995-2018 and are in need of improvement.

Telomere length associates with chronological age and mortality across racially diverse pulmonary fibrosis cohorts

“…However, this technique allowed us to assess LTLs on archived samples. Third, our study is focused on differences across race/ethnic groups, complex social constructs that often reflect an individual's perception of their familial origin, cultural environment, and genetic makeup 37 . Fourth, it is also possible that the observed association of short telomeres with a detrimental survival pattern is due to mortality from comorbidities in PF, including coronary artery disease, pulmonary hypertension, dyslipidemia, combined pulmonary fibrosis and emphysema, obstructive sleep apnea, gastro-esophageal reflux disease, among others [38][39][40] .…”

Racial and ethnic disparities in emergency department–initiated buprenorphine across five health care systems

“…Ethnicity was categorized as Hispanic, non‐Hispanic, and other/unknown. Race and ethnicity were treated as related but distinct dimensions of social identity; thus, race and ethnicity were both examined independently as separate social constructs for the primary outcome as well as combined into a single ethnoracial coding construct as a sensitivity analysis with the following categories: Hispanic, White non‐Hispanic, Black non‐Hispanic, and other 41,42 …”

“…Race and ethnicity were treated as related but distinct dimensions of social identity; thus, race and ethnicity were both examined independently as separate social constructs for the primary outcome as well as combined into a single ethnoracial coding construct as a sensitivity analysis with the following categories: Hispanic, White non-Hispanic, Black non-Hispanic, and other. 41,42 Patient-, clinician-, and site-level variables Patient-level variables included patient age, gender, insurance, and opioid-related ED discharge diagnoses (opioid overdose, opioid withdrawal, other OUD diagnosis). ED clinician variables included gender, age (categorized as <35, 35-44, and >45 years old), professional role (attending, fellow, advanced practitioner, resident), and DEA Xwaiver status of the treating clinician (not waivered, waivered before the start of the study, waivered after the start of the study).…”

Sulfur dioxide reduction at coal-fired power plants in North Carolina and associations with preterm birth among surrounding residents

“…Although the birth certificate collection form(s) and subsequent birth records database uses gendered language (e.g., “mother,” “maternal”), we purposely use the more inclusive term “gestational parent” to represent the pregnant person who gave birth. 37 Information about gestational parent race and ethnicity had dimensions of self-classification at the time of data collection (i.e., the race and ethnicity checked on the birth certificate worksheet had constrained options, 38 and were further bridged into combined race/ethnicity categories by the National Center for Health Statistics for consistency and comparability of this variable over time and across data collection systems. 39…”