Improving Social Justice in COVID-19 Health Research: Interim Guidelines for Reporting Health Equity in Observational Studies.

Alba Antequera ,Julian Little ,Xiaoqin Wang ,Stuart G Nicholls ,Clara Juandó-Prats ,Melissa K Sharp ,Anita Rizvi ,Elizabeth Tanjong Ghogomu ,Janet Jull ,Daeria O Lawson ,Miriam Nkangu ,Zulfiqar A Bhutta ,Catherine Chamberlain ,Tanya Horsley ,Sarah Funnell ,Gabriel Rada ,Francisca Verdugo-Paiva ,Lawrence Mbuagbaw ,Elizabeth Kristjansson ,Mark Petticrew ,Regina Greer-Smith ,Haoxiang Wang ,Holly Ellingwood ,Marc T Avey ,Stephen G Noorduyn ,Peter Tugwell ,Larissa Shamseer ,Omar Dewidar ,Janice Tufte ,Damian K Francis ,Vivian Welch

doi:10.3390/ijerph18179357

Abstract

The COVID-19 pandemic has highlighted the global imperative to address health inequities. Observational studies are a valuable source of evidence for real-world effects and impacts of implementing COVID-19 policies on the redistribution of inequities. We assembled a diverse global multi-disciplinary team to develop interim guidance for improving transparency in reporting health equity in COVID-19 observational studies. We identified 14 areas in the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) checklist that need additional detail to encourage transparent reporting of health equity. We searched for examples of COVID-19 observational studies that analysed and reported health equity analysis across one or more social determinants of health. We engaged with Indigenous stakeholders and others groups experiencing health inequities to co-produce this guidance and to bring an intersectional lens. Taking health equity and social determinants of health into account contributes to the clinical and epidemiological understanding of the disease, identifying specific needs and supporting decision-making processes. Stakeholders are encouraged to consider using this guidance on observational research to help provide evidence to close the inequitable gaps in health outcomes.

Highlights

We identified 14 items across six domains of the STROBE checklist that need to be adapted to ensure transparent reporting of health equity
Given the magnitude of inequities in health and the societal burden of COVID-19, applying an equity lens to observational research can contribute to a better understanding of who may experience vulnerability, including exposure to the virus, response to treatment, community effectiveness, and the consequences of public health policies and other measures
We propose this interim guidance as a structure for integrating an equity lens within the design, analysis, and interpretation and reporting of results in observational research

Summary

Introduction

Bruyère Research Institute, University of Ottawa, Ottawa, ON K1N 5C8, Canada; Healthcare Research Associates, LLC/The S.T.A.R. Initiative, Los Angeles, CA 90033, USA; Research Unit, Royal College of Physicians and Surgeons of Canada, Ottawa, ON K1S 5N8, Canada

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