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Measurement Issues in Health Disparities Research


  • Mildred Ramírez,

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    • Address correspondence to Mildred Ramírez, Ph.D., Research Division, The Hebrew Home for the Aged at Riverdale, 5901 Palisade Avenue, Riverdale, NY 10471. Marvella Ford, Ph.D., is with the Department of Biostatistics, Bioinformatics, and Epidemiology, Medical University of South Carolina, Charleston, SC. Anita Stewart, Ph.D., Professor, is with the Institute for Health & Aging, University of California–San Francisco, San Francisco, CA. Jeanne Teresi, Ed.D., Ph.D., is with the Columbia University Stroud Center, Faculty of Medicine, and the New York State Psychiatric Institute, The Hebrew Home for the Aged at Riverdale, Research Division, Riverdale, NY.

  • Marvella E. Ford,

  • Anita L. Stewart,

  • Jeanne A. Teresi


Background. Racial and ethnic disparities in health and health care have been documented; the elimination of such disparities is currently part of a national agenda. In order to meet this national objective, it is necessary that measures identify accurately the true prevalence of the construct of interest across diverse groups. Measurement error might lead to biased results, e.g., estimates of prevalence, magnitude of risks, and differences in mean scores. Addressing measurement issues in the assessment of health status may contribute to a better understanding of health issues in cross-cultural research.

Objective. To provide a brief overview of issues regarding measurement in diverse populations.

Findings. Approaches used to assess the magnitude and nature of bias in measures when applied to diverse groups include qualitative analyses, classic psychometric studies, as well as more modern psychometric methods. These approaches should be applied sequentially, and/or iteratively during the development of measures.

Conclusions. Investigators performing comparative studies face the challenge of addressing measurement equivalence, crucial for obtaining accurate results in cross-cultural comparisons.