Home > Review Articles > Ethnic disparities > How differing methods of ascribing ethnicity and socio-economic status affect risk estimates for hospitalisation with infectious disease

How differing methods of ascribing ethnicity and socio-economic status affect risk estimates for hospitalisation with infectious disease

Making Education Easy

Authors:
Summary:

This study was conducted within the Growing Up in New Zealand (GUiNZ) longitudinal birth cohort, which enrolled 6,822 pregnant women in the Auckland, Counties-Manukau and Waikato District Health Board areas due to deliver in 2009 or 2010. The GUiNZ cohort includes representative proportions of Māori, Pacific, and socioeconomically deprived families. This analysis of GUiNZ data reports rates of hospitalisation for an infectious disease (ID) within the first 5 years of life, an outcome that is known to be linked to greater socioeconomic deprivation. Using only cross-sectional data at 4.5 years of child age, this analysis included 5,602 children and compared different methods of ethnicity and socioeconomic deprivation, to determine the most accurate measures. Primary caregivers assigned the children to either a self-prioritised ethnicity (i.e. the main ethnic group with which their child identified), a total response ethnicity (i.e. the ethnic group or groups their child belonged to), or single-combined ethnic groups (i.e. assigning the child to a single or combination ethnic group matching their combination of ethnicities). Socioeconomic status was measured using household income, census-derived and survey-derived deprivation indices. The easiest category of child ethnicity to analyse was the self-prioritisation group. Total response was complicated by mixed ethnicity allowing overlap between groups. The researchers had to aggregate small groups for the single-combined ethnicity cohort to maintain statistical power, but this measure offered greater detail. Whichever method was used to ascribe ethnicity, Māori and Pacific children were at greater risk of ID hospitalisation, as were children in the most socioeconomically deprived households. The magnitude of these effects differed according to whichever methodology was used. Household income was affected by non-random missing data. The census-derived deprivation index offered a high level of completeness with some risk of multicollinearity and concerns regarding the ecological fallacy (i.e. making assumptions about individuals within a given decile). The survey-derived index contained an additional 8 questions but proved acceptable to participants and provided individualised data, so largely avoided the ecological fallacy concerns affecting the censusderived deprivation index.

Comment:
One of the strengths of Growing Up in New Zealand is its monitoring of ethnicity, and how it is ascribed to tamariki, over time. This paper provides valuable and pragmatic information about the collection and reporting of ethnicity and socioeconomic status and the impacts on analysis and results.
Reference: Epidemiol Infect. 2018;147:e40
Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

Research Review publications are intended for New Zealand health professionals.

Disclaimer: This publication is not intended as a replacement for regular medical education but to assist in the process. The reviews are a summarised interpretation of the published study and reflect the opinion of the writer rather than those of the research group or scientific journal. It is suggested readers review the full trial data before forming a final conclusion on its merits.

Related Articles

Despite overall improvement in life expectancy in New Zealand, according to a cause-specific decomposition analysis

A retrospective study has highlighted ethnic disparities in the utilisation of epidural analgesia at Christchurch

Explore Māori Health Reviews

Dive into our publications and videos content from over 50 areas of medicine including Cardiology, Diabetes, Oncology, Haematology and Psychiatry. 

It looks like you are closest to our Australia site.

Australia
Australia
Find Reviews in Your Clinical Area
Please select your country of practice.
Terms and Conditions

Website terms of use 

By using our website, you agree to follow these terms and conditions. 

 

Privacy policy 

We take your privacy seriously. To understand how we collect, use, and protect your information, please read our Privacy Policy, which is part of these terms. 

 

Copyright and use of website content 

The content of our website is protected by copyright, trademarks, and other legal rights. You can: view, download, or print a single copy of content for your personal or professional use. 

You cannot:  copy, modify, or distribute website content, or use our website content for commercial purposes or in other works without permission. 

 

Links to third-party websites 

The Research Review website may link to third-party websites for your convenience. However: 

We do not endorse or approve their products, services, or actions. 

We are not responsible for their content or how they operate. 

There is no formal partnership between us and third parties unless we clearly state otherwise. 

 

Disclaimer and limitation of liability 

We do our best to keep the information on our website accurate, but we do not guarantee that it is always correct or up to date. 

To the fullest extent allowed by law, we are not responsible for: 

Any loss, damage, or costs you may suffer from using (or being unable to use) our website. 

Any decisions you make based on the information provided. 

Any business losses, such as lost profits, lost data, or business interruptions. 

 

Governing law 

These terms are governed by New Zealand law. If there is a dispute, it must be resolved in a New Zealand court.