Reporting of equity in observational epidemiology: A methodological review

Omar Dewidar, Ali Al-Zubaidi, Mostafa Bondok, Leenah Abdelrazeq, Jimmy Huang, Alyssa Jearvis, Lucy C. Barker, Nour Elmestekawy, Elizabeth Goghomu, Tamara Rader, Janice Tufte, Regina Greer-Smith, Hugh S. Waddington, Stuart G. Nicholls, Julian Little, Billie Jo Hardy, Tanya Horsley, Taryn Young, Luis Gabriel Cuervo, Melissa K. SharpCatherine Chamberlain, Beverley Shea, Peter Craig, Daeria O. Lawson, Anita Rizvi, Charles S. Wiysonge, Tamara Kredo, Damian Francis, Elizabeth Kristjansson, Zulfiqar Bhutta, Alba Antequera, G. J. Melendez-Torres, Tomas Pantoja, Xiaoqin Wang, Janet Jull, Janet Hatcher Roberts, Sarah Funnell, Howard White, Alison Krentel, Michael Johnson Mahande, Jacqueline Ramke, George Wells, Jennifer Petkovic, Kevin Pottie, Loveline Niba, Cindy Feng, Miriam N. Nguliefem, Peter Tugwell, Lawrence Mbuagbaw, Vivian Welch

Research output: Contribution to journalArticlepeer-review


Background: Observational studies can inform how we understand and address persisting health inequities through the collection, reporting and analysis of health equity factors. However, the extent to which the analysis and reporting of equity-relevant aspects in observational research are generally unknown. Thus, we aimed to systematically evaluate how equity-relevant observational studies reported equity considerations in the study design and analyses. Methods: We searched MEDLINE for health equity-relevant observational studies from January 2020 to March 2022, resulting in 16 828 articles. We randomly selected 320 studies, ensuring a balance in focus on populations experiencing inequities, country income settings, and coronavirus disease 2019 (COVID-19) topic. We extracted information on study design and analysis methods. Results: The bulk of the studies were conducted in North America (n = 95, 30%), followed by Europe and Central Asia (n = 55, 17%). Half of the studies (n = 171, 53%) addressed general health and well-being, while 49 (15%) focused on mental health conditions. Two-thirds of the studies (n = 220, 69%) were cross-sectional. Eight (3%) engaged with populations experiencing inequities, while 22 (29%) adapted recruitment methods to reach these populations. Further, 67 studies (21%) examined interaction effects primarily related to race or ethnicity (48%). Two-thirds of the studies (72%) adjusted for characteristics associated with inequities, and 18 studies (6%) used flow diagrams to depict how populations experiencing inequities progressed throughout the studies. Conclusions: Despite over 80% of the equity-focused observational studies providing a rationale for a focus on health equity, reporting of study design features relevant to health equity ranged from 0-95%, with over half of the items reported by less than one-quarter of studies. This methodological study is a baseline assessment to inform the development of an equity-focussed reporting guideline for observational studies as an extension of the well-known Strengthening Reporting of Observational Studies in Epidemiology (STROBE) guideline.

Original languageEnglish
Pages (from-to)4046
Number of pages1
JournalJournal of Global Health
Publication statusPublished - 1 Mar 2024


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