Motivations for investigating health inequities in observational epidemiology: a content analysis of 320 studies

Omar Dewidar, Georgia McHale, Ali Al Zubaidi, Mostafa Bondok, Leenah Abdelrazeq, Jimmy Huang, Alyssa Jearvis, Khadija Aliyeva, Amjad Alghamyan, Fatima Jahel, Regina Greer-Smith, Janice Tufte, Lucy C. Barker, Nour Elmestekawy, Melissa K. Sharp, Tanya Horsley, Clara Juandro Prats, Janet Jull, Luke Wolfenden, Luis Gabriel CuervoBillie Jo Hardy, Janet Hatchet Roberts, Elizabeth Ghogomu, Ekwaro Obuku, Ebenezer Owusu-Addo, Stuart G. Nicholls, Lawrence Mbuagbaw, Sarah Funnell, Bev Shea, Anita Rizvi, Peter Tugwell, Zulfiqar Bhutta, Vivian Welch, G. J. Melendez-Torres

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Objectives: To enhance equity in clinical and epidemiological research, it is crucial to understand researcher motivations for conducting equity-relevant studies. Therefore, we evaluated author motivations in a randomly selected sample of equity-relevant observational studies published during the COVID-19 pandemic. Study Design and Setting: We searched MEDLINE for studies from 2020 to 2022, resulting in 16,828 references. We randomly selected 320 studies purposefully sampled across income setting (high vs low–middle-income), COVID-19 topic (vs non–COVID-19), and focus on populations experiencing inequities. Of those, 206 explicitly mentioned motivations which we analyzed thematically. We used discourse analysis to investigate the reasons behind emerging motivations. Results: We identified the following motivations: (1) examining health disparities, (2) tackling social determinants to improve access, and (3) addressing knowledge gaps in health equity. Discourse analysis showed motivations stem from commitments to social justice and recognizing the importance of highlighting it in research. Other discourses included aspiring to improve health-care efficiency, wanting to understand cause-effect relationships, and seeking to contribute to an equitable evidence base. Conclusion: Understanding researchers' motivations for assessing health equity can aid in developing guidance that tailors to their needs. We will consider these motivations in developing and sharing equity guidance to better meet researchers' needs.

Original languageEnglish
Article number111283
JournalJournal of Clinical Epidemiology
Publication statusPublished - Apr 2024


  • Discourse
  • Equity
  • Motivation
  • Observational studies
  • Qualitative study design
  • Reporting guidelines
  • Themes


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