Improving the reporting of health equity in observational studies

Article type
Authors
Dewidar O1, Funnell S2, Ghogomu E1, Jull J2, Lee N1, Lesperance M3, Martel A1, Mbuagbaw L4, Simpson D2, Wang X5, Welch V1, Wick C1
1Bruyère Research Institute, Ottawa, ON, Canada
2Queen's University, Kingston, ON, Canada
3Thunder Bay Regional Health Sciences Centre, Thunder Bay, ON, Canada
4McMaster University, Hamilton, ON, Canada
5University of Ottawa Heart Institute, Ottawa, ON, Canada
Abstract
Background
Tackling pervasive and enduring health inequities driven by structural inequities that limit health opportunities across gender, race, ethnicity, age, and other factors requires a global moral effort. Observational studies frequently collect these data and can contribute to our understanding of the impact of health and structural oppression. However, the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guideline lacks specific guidance on reporting health equity.
Objectives
The objective is to develop a STROBE-Equity reporting guideline extension.
Methods
We are a diverse team across gender, age, ethnicity, Indigenous background, discipline, geography, lived experience of health inequity, and knowledge user perspectives. We report on 3 phases to: (1) assess existing guidance and reporting of health equity in observational studies, (2) seek wide international feedback on draft guidance, and (3) establish global consensus. The next 2 phases will include evaluating in partnership with Indigenous contributors the relevance to Indigenous peoples who have globally experienced the oppressive legacy of colonization and widely disseminating and seeking endorsement from relevant knowledge users.
Results
We completed a scoping review of existing guidance that identified 14 new items to consider, including reporting team positionality as well as lived experience of racism. We completed a methods study of 320 observational studies, which found variation in reporting health equity across our proposed reporting items from 3% to 95%. For example, only 3% of studies reported engaging with populations who had experienced inequities in design of the study, 21% examined interaction effects across 1 or more equity factors, and 72% adjusted their analyses across 1 or more equity factors. In the global survey, we found >70% agreement for 23 equity-extension items. We found <60% agreement for 15 items, which will be discussed at a consensus meeting to be held in April 2024. The resulting guidance and items will be presented at the Global Evidence Summit.
Conclusions
Achieving health equity requires advancing health research reporting practices. The implementation of the STROBE-Equity guidelines will enable a better awareness and understanding of health inequities through better reporting.