Questioning the discriminatory accuracy of broad migrant categories in public health: self-rated health in Sweden
Mulinari, Shai LU ; Bredström, Anna and Merlo, Juan LU
(2015)
In European Journal of Public Health
25(6).
p.911-917
- Abstract
- BACKGROUND:
Differences between natives and migrants in average risk for poor self-rated health (SRH) are well documented, which has lent support to proposals for interventions targeting disadvantaged minority groups. However, such proposals are based on measures of association that neglect individual heterogeneity around group averages and thereby the discriminatory accuracy (DA) of the categories used (i.e. their ability to discriminate the individuals with poor and good SRH, respectively). Therefore, applying DA measures rather than only measures of association our study revisits the value of broad native and migrant categorizations for predicting SRH.
DESIGN, SETTING AND PARTICIPANTS:
We... (More) - BACKGROUND:
Differences between natives and migrants in average risk for poor self-rated health (SRH) are well documented, which has lent support to proposals for interventions targeting disadvantaged minority groups. However, such proposals are based on measures of association that neglect individual heterogeneity around group averages and thereby the discriminatory accuracy (DA) of the categories used (i.e. their ability to discriminate the individuals with poor and good SRH, respectively). Therefore, applying DA measures rather than only measures of association our study revisits the value of broad native and migrant categorizations for predicting SRH.
DESIGN, SETTING AND PARTICIPANTS:
We analyzed 27 723 individuals aged 18-80 who responded to a 2008 Swedish public health survey. We performed logistic regressions to estimate odds ratios (ORs), predicted risks and the area under the receiver operating characteristic curve (AU-ROC) as a measure of epidemiological DA.
RESULTS:
Being born abroad was associated with higher odds of poor SRH (OR = 1.75), but the AU-ROC of this variable only added 0.02 units to the AU-ROC for age alone (from 0.53 to 0.55). The AU-ROC increased, but remained unsatisfactorily low (0.62), when available social and demographic variables were included.
CONCLUSIONS:
Our results question the use of broad native/migrant categorizations as instruments for forecasting individual SRH. Such simple categorizations have a very low DA and should be abandoned in public health practice. Measures of association and DA should be reported together whenever an intervention is being considered, especially in the area of ethnicity, migration and health. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/7357660
- author
- Mulinari, Shai
LU
; Bredström, Anna
and Merlo, Juan
LU
- organization
- publishing date
- 2015
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- discriminatory accuracy, sensitivity and specificity, ethnicity, public health, self-rated health, migration
- in
- European Journal of Public Health
- volume
- 25
- issue
- 6
- pages
- 911 - 917
- publisher
- Oxford University Press
- external identifiers
-
- wos:000367163900004
- scopus:84958176922
- pmid:26072519
- ISSN
- 1101-1262
- DOI
- 10.1093/eurpub/ckv099
- project
- Swedish genes?
- Multilevel analysis of individual heterogeneity
- language
- English
- LU publication?
- yes
- id
- 89a76857-e105-42f3-a313-8d5205fdf32e (old id 7357660)
- date added to LUP
- 2016-04-01 10:45:17
- date last changed
- 2022-02-25 05:23:16
@article{89a76857-e105-42f3-a313-8d5205fdf32e,
abstract = {{BACKGROUND:<br/><br>
<br/><br>
Differences between natives and migrants in average risk for poor self-rated health (SRH) are well documented, which has lent support to proposals for interventions targeting disadvantaged minority groups. However, such proposals are based on measures of association that neglect individual heterogeneity around group averages and thereby the discriminatory accuracy (DA) of the categories used (i.e. their ability to discriminate the individuals with poor and good SRH, respectively). Therefore, applying DA measures rather than only measures of association our study revisits the value of broad native and migrant categorizations for predicting SRH.<br/><br>
DESIGN, SETTING AND PARTICIPANTS:<br/><br>
<br/><br>
We analyzed 27 723 individuals aged 18-80 who responded to a 2008 Swedish public health survey. We performed logistic regressions to estimate odds ratios (ORs), predicted risks and the area under the receiver operating characteristic curve (AU-ROC) as a measure of epidemiological DA.<br/><br>
RESULTS:<br/><br>
<br/><br>
Being born abroad was associated with higher odds of poor SRH (OR = 1.75), but the AU-ROC of this variable only added 0.02 units to the AU-ROC for age alone (from 0.53 to 0.55). The AU-ROC increased, but remained unsatisfactorily low (0.62), when available social and demographic variables were included.<br/><br>
CONCLUSIONS:<br/><br>
<br/><br>
Our results question the use of broad native/migrant categorizations as instruments for forecasting individual SRH. Such simple categorizations have a very low DA and should be abandoned in public health practice. Measures of association and DA should be reported together whenever an intervention is being considered, especially in the area of ethnicity, migration and health.}},
author = {{Mulinari, Shai and Bredström, Anna and Merlo, Juan}},
issn = {{1101-1262}},
keywords = {{discriminatory accuracy; sensitivity and specificity; ethnicity; public health; self-rated health; migration}},
language = {{eng}},
number = {{6}},
pages = {{911--917}},
publisher = {{Oxford University Press}},
series = {{European Journal of Public Health}},
title = {{Questioning the discriminatory accuracy of broad migrant categories in public health: self-rated health in Sweden}},
url = {{https://lup.lub.lu.se/search/files/2108113/7357773.pdf}},
doi = {{10.1093/eurpub/ckv099}},
volume = {{25}},
year = {{2015}},
}