Journal article
Do small effects matter more in vulnerable populations? an investigation using Environmental influences on Child Health Outcomes (ECHO) cohorts
BMC public health, v 24(1), pp 2655-13
28 Sep 2024
PMID: 39342237
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
A major challenge in epidemiology is knowing when an exposure effect is large enough to be clinically important, in particular how to interpret a difference in mean outcome in unexposed/exposed groups. Where it can be calculated, the proportion/percentage beyond a suitable cut-point is useful in defining individuals at high risk to give a more meaningful outcome. In this simulation study we compute differences in outcome means and proportions that arise from hypothetical small effects in vulnerable sub-populations.
Data from over 28,000 mother/child pairs belonging to the Environmental influences on Child Health Outcomes Program were used to examine the impact of hypothetical environmental exposures on mean birthweight, and low birthweight (LBW) (birthweight < 2500g). We computed mean birthweight in unexposed/exposed groups by sociodemographic categories (maternal education, health insurance, race, ethnicity) using a range of hypothetical exposure effect sizes. We compared the difference in mean birthweight and the percentage LBW, calculated using a distributional approach.
When the hypothetical mean exposure effect was fixed (at 50, 125, 167 or 250g), the absolute difference in % LBW (risk difference) was not constant but varied by socioeconomic categories. The risk differences were greater in sub-populations with the highest baseline percentages LBW: ranging from 3.1-5.3 percentage points for exposure effect of 125g. Similar patterns were seen for other mean exposure sizes simulated.
Vulnerable sub-populations with greater baseline percentages at high risk fare worse when exposed to a small insult compared to the general population. This illustrates another facet of health disparity in vulnerable individuals.
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Details
- Title
- Do small effects matter more in vulnerable populations? an investigation using Environmental influences on Child Health Outcomes (ECHO) cohorts
- Creators
- Janet L Peacock - Dartmouth CollegeSusana Diaz Coto - Dartmouth CollegeJudy R Rees - Dartmouth CollegeOdile Sauzet - Bielefeld UniversityElizabeth T Jensen - Wake Forest UniversityRaina Fichorova - Brigham and Women's HospitalAnne L Dunlop - Emory UniversityNigel Paneth - Michigan State UniversityAmy Padula - University of California, San FranciscoTracey Woodruff - University of California, San FranciscoRachel Morello-Frosch - University of California, BerkeleyJessica Trowbridge - University of California, San FranciscoDana Goin - University of Illinois Urbana-ChampaignLuis E Maldonado - University of Southern CaliforniaZhongzheng Niu - University of Southern CaliforniaAkhgar Ghassabian - Harvard UniversityLeonardo Transande - New York UniversityAssiamira Ferrara - Kaiser PermanenteLisa A Croen - Kaiser PermanenteStacey Alexeeff - Kaiser PermanenteCarrie Breton - University of Southern CaliforniaAugusto Litonjua - University of Rochester Medical CenterThomas G O'Connor - University of Rochester Medical CenterKristen Lyall - Drexel UniversityHeather Volk - Johns Hopkins UniversityAkram Alshawabkeh - Northeastern UniversityJustin Manjourides - Northeastern UniversityCarlos A Camargo, Jr - Massachusetts General HospitalDana Dabelea - University of Colorado Anschutz Medical CampusChristine W Hockett - University of South DakotaCasper G Bendixsen - Marshfield ClinicIrva Hertz-Picciotto - University of California, DavisRebecca J Schmidt - University of California, DavisAlison E Hipwell - University of PittsburghKate Keenan - University of ChicagoCatherine Karr - University of WashingtonKaja Z LeWinn - University of California, San FranciscoBarry Lester - Brown UniversityMarie Camerota - Brown UniversityJody Ganiban - George Washington UniversityCynthia McEvoy - University of PortlandMichael R Elliott - University of Michigan–Ann ArborSheela Sathyanarayana - University of WashingtonNan Ji - University of Southern CaliforniaJoseph M Braun - Brown UniversityMargaret R Karagas - Dartmouth CollegeProgram Collaborators for Environmental influences on Child Health Outcomes
- Publication Details
- BMC public health, v 24(1), pp 2655-13
- Publisher
- BMC; LONDON
- Number of pages
- 13
- Grant note
- Environmental Influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health (NIH): U2COD023375, U24OD023382, U24OD023319 Office of Behavioral and Social Science Research (PRO-Core): UH3OD023251, UH3OD023332, UH3OD023253, UH3OD023248, UH3OD023313, UH3OD023328, UH3OD023318, UH3OD023279, UH3OD023289, UH3OD023282, UH3OD023287, UH3OD023365, UH3OD023244, UH3OD023275, UH3OD023271, UH3OD023389, UH3OD023268, UH3OD023288, UH3OD023342, UH3OD023349, UH3OD023286, UH3OD023285, UH3OD023290, UH3OD023272, UH3OD023249, UH3OD023305, UH3OD023337
Research reported in this publication was supported by the Environmental Influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health (NIH), under award numbers U2COD023375 (Coordinating Center), U24OD023382 (Data Analysis Center), U24OD023319 with co-funding from the Office of Behavioral and Social Science Research (PRO-Core), UH3OD023251 (Alshawabkeh), UH3OD023332 (Trasande), UH3OD023253 (Camargo), UH3OD023248 (Dabelea), UH3OD023313 (Koinis Mitchell), UH3OD023328 (Duarte), UH3OD023318 (Dunlop), UH3OD023279 (Elliott), UH3OD023289 (Ferrara), UH3OD023282 (Gern), UH3OD023287 (Breton), UH3OD023365 (Hertz-Picciotto), UH3OD023244 (Hipwell), UH3OD023275 (Karagas), UH3OD023271 (Karr), UH3OD023389 (Leve), UH3OD023268 (Weiss), UH3OD023288 (McEvoy), UH3OD023342 (Lyall), UH3OD023349 (O'Connor), UH3OD023286 (Oken), UH3OD023285 (Kerver), UH3OD023290 (Herbstman), UH3OD023272 (Schantz), UH3OD023249 (Stanford), UH3OD023305 (Trasande), UH3OD023337 (Wright).
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- A.J. Drexel Autism Institute
- Web of Science ID
- WOS:001324781600008
- Scopus ID
- 2-s2.0-85205336209
- Other Identifier
- 991021906596004721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Public, Environmental & Occupational Health