American Journal of Epidemiology Advance Access originally published online on March 15, 2008
American Journal of Epidemiology 2008 167(8):889-899; doi:10.1093/aje/kwn016
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
PRACTICE OF EPIDEMIOLOGY |
An Overview of Methods for Monitoring Social Disparities in Cancer with an Example Using Trends in Lung Cancer Incidence by Area-Socioeconomic Position and Race-Ethnicity, 1992–2004
1 Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
2 Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD
Correspondence to Dr. Sam Harper, Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, 1020 Pine Avenue West, Room 17B, Montreal, Quebec H3A 1A2, Canada (e-mail: sam.harper{at}mcgill.ca).
Received for publication July 11, 2007. Accepted for publication October 29, 2007.
The authors provide an overview of methods for summarizing social disparities in health using the example of lung cancer. They apply four measures of relative disparity and three measures of absolute disparity to trends in US lung cancer incidence by area-socioeconomic position and race-ethnicity from 1992 to 2004. Among females, measures of absolute and relative disparity suggested that area-socioeconomic and race-ethnic disparities increased over these 12 years but differed widely with respect to the magnitude of the change. Among males, the authors found substantial disagreement among summary measures of relative disparity with respect to the magnitude and the direction of change in disparities. Among area-socioeconomic groups, the index of disparity increased by 47% and the relative concentration index decreased by 116%, while for race-ethnicity the index of disparity increased by 36% and the Theil index increased by 13%. The choice of a summary measure of disparity may affect the interpretation of changes in health disparities. Important issues to consider are the reference point from which differences are measured, whether to measure disparity on the absolute or relative scale, and whether to weight disparity measures by population size. A suite of indicators is needed to provide a clear picture of health disparity change.
epidemiologic methods; ethnic groups; health status disparities; lung neoplasms; socioeconomic factors
Abbreviations: SE, standard error; SEER, Surveillance, Epidemiology, and End Results
Editor's note: An invited commentary on this article appears on page 900, and the authors' response appears on page 905.
CiteULike 
Connotea 
Del.icio.us What's this?
Related articles in Am. J. Epidemiol.:
- Harper et al. Respond to "Measuring Social Disparities in Health"
- Sam Harper, John Lynch, Stephen C. Meersman, Nancy Breen, William W. Davis, and Marsha E. Reichman
Am. J. Epidemiol. 2008 167: 905-907.[Extract] [FREE Full Text] - Invited Commentary: Measuring Social Disparities in Health—What Was the Question Again?
- Lynne C. Messer
Am. J. Epidemiol. 2008 167: 900-904.[Abstract] [FREE Full Text]
This article has been cited by other articles:
|
|
 |
|
  P Smith, J Frank, and C Mustard Trends in educational inequalities in smoking and physical activity in Canada: 1974-2005 J Epidemiol Community Health, April 1, 2009; 63(4): 317 - 323. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Harper, J. Lynch, S. C. Meersman, N. Breen, W. W. Davis, and M. C. Reichman Trends in Area-Socioeconomic and Race-Ethnic Disparities in Breast Cancer Incidence, Stage at Diagnosis, Screening, Mortality, and Survival among Women Ages 50 Years and Over (1987-2005) Cancer Epidemiol. Biomarkers Prev., January 1, 2009; 18(1): 121 - 131. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Harper, J. Lynch, S. C. Meersman, N. Breen, W. W. Davis, and M. E. Reichman THE AUTHORS REPLY Am. J. Epidemiol., November 15, 2008; 168(10): 1216 - 1216. [Full Text] [PDF]
|
|
|
|
|
|
R. S. Bhopal RE: "AN OVERVIEW OF METHODS FOR MONITORING SOCIAL DISPARITIES IN CANCER WITH AN EXAMPLE USING TRENDS IN LUNG CANCER INCIDENCE BY AREA-SOCIOECONOMIC POSITION AND RACE-ETHNICITY, 1992-2004" Am. J. Epidemiol., November 15, 2008; 168(10): 1214 - 1216. [Full Text] [PDF]
|
|
|
|
|
|
N. F. Cheng, P. Z. Han, and S. A. Gansky Methods and Software for Estimating Health Disparities: The Case of Children's Oral Health Am. J. Epidemiol., October 15, 2008; 168(8): 906 - 914. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Harper, J. Lynch, S. C. Meersman, N. Breen, W. W. Davis, and M. E. Reichman Harper et al. Respond to "Measuring Social Disparities in Health" Am. J. Epidemiol., April 15, 2008; 167(8): 905 - 907. [Full Text] [PDF]
|
|
|
|
|
|
L. C. Messer Invited Commentary: Measuring Social Disparities in Health--What Was the Question Again? Am. J. Epidemiol., April 15, 2008; 167(8): 900 - 904. [Abstract] [Full Text] [PDF]
|
|