Statistical Aspects of Racial and Ethnic Health Disparities

Measurement and analysis of racial and ethnic health disparities are vital functions of government and academia in diverse societies, but the statistical methods for accomplishing this work are underdeveloped. Issues of measurement, aggregation, adjustment, choice of scale, internal validity, and generalizability are all paramount. Measurement of race and ethnicity is complicated by the fact that, as identities that form through historical and political processes, they are not stable over time and place, nor are they objectively verifiable. Similarly, it is impossible to specify an optimal adjustment set, because adjustments are functions of ethical judgments, not statistical criteria. Additional complications arise when decomposing disparities in relation to measured pathways, as well as in the modeling of multiple intersectional strata. The ethical considerations in model selection imply that measurement and modeling of health disparities can never be a purely statistical activity, but instead must be conducted in relation to a theory of justice.