Disparate Measures Research Articles

Disparities in Tuberculosis Incidence by Race and Ethnicity Among the U.S.-Born Population in the United States, 2011 to 2021 : An Analysis of National Disease Registry Data.

Elevated tuberculosis (TB) incidence rates have recently been reported for racial/ethnic minority populations in the United States. Tracking such disparities is important for assessing progress toward national health equity goals and implementing change. To quantify trends in racial/ethnic disparities in TB incidence among U.S.-born persons. Time-series analysis of national TB registry data for 2011 to 2021. United States. U.S.-born persons stratified by race/ethnicity. TB incidence rates, incidence rate differences, and incidence rate ratios compared with non-Hispanic White persons; excess TB cases (calculated from incidence rate differences); and the index of disparity. Analyses were stratified by sex and by attribution of TB disease to recent transmission and were adjusted for age, year, and state of residence. In analyses of TB incidence rates for each racial/ethnic population compared with non-Hispanic White persons, incidence rate ratios were as high as 14.2 (95% CI, 13.0 to 15.5) among American Indian or Alaska Native (AI/AN) females. Relative disparities were greater for females, younger persons, and TB attributed to recent transmission. Absolute disparities were greater for males. Excess TB cases in 2011 to 2021 represented 69% (CI, 66% to 71%) and 62% (CI, 60% to 64%) of total cases for females and males, respectively. No evidence was found to indicate that incidence rate ratios decreased over time, and most relative disparity measures showed small, statistically nonsignificant increases. Analyses assumed complete TB case diagnosis and self-report of race/ethnicity and were not adjusted for medical comorbidities or social determinants of health. There are persistent disparities in TB incidence by race/ethnicity. Relative disparities were greater for AI/AN persons, females, and younger persons, and absolute disparities were greater for males. Eliminating these disparities could reduce overall TB incidence by more than 60% among the U.S.-born population. Centers for Disease Control and Prevention.

Enhancing Cybersecurity in Climate Technology Transfer: The Interaction of Environmental Law with Digital Security

Abstract The Climate Change Convention, together with developed and developing countries, is taking measures to be more effective in combating climate change with the gear of modern methods and innovations. However, the technology mechanism has launched a series of initiatives aimed at exploring the potential of artificial intelligence to accelerate and scale up groundbreaking climate solutions, both in mitigation and adaptation efforts. To address the research questions, a comprehensive literature review is conducted to identify existing gaps and establish a foundational understanding of the legal and cybersecurity landscape in climate technology transfer. Different countries and organizations may adopt disparate cybersecurity measures, making it challenging to ensure a cohesive and standardized approach to safeguarding climate-related technologies. This fragmentation could result in inefficiencies, confusion, and a lack of interoperability. The urgency for a holistic and adaptive approach at the confluence of environmental law and digital security, the evolution of legal frameworks, the fortification of cybersecurity measures, and the ethical dimensions of technology transfer are integral components of a resilient foundation for a sustainable and secure future in climate technology exchange.

Absolute and relative disparity mechanisms revealed by an equivalent noise analysis

The precision of stereopsis and vergence are ultimately limited by internal binocular disparity noise. Here we propose an equivalent noise model with both global and local internal disparity noises to provide a unified explanation of both absolute and relative disparity thresholds. To test this model, we developed a psychophysical procedure to measure the equivalent internal disparity noise by adding external disparity noise to random-Gabor-patch stereograms. We used the method of constant stimuli to measure the minimum and maximum disparity thresholds (Dmin and Dmax) for both absolute and relative disparity. Consistent with previous studies, we found that Dmin thresholds are substantially worse for absolute disparity than for relative disparity. We tested three relative disparity mechanisms: (1) the difference between the monocular separations of targets projecting to the two eyes; (2) the direct measurement of relative disparity; and (3) the difference of absolute disparities of targets. Computing the difference of absolute disparities when detecting relative disparity, Mechanism 3 cancels global noise, resulting in a much lower relative Dmin threshold, and provides a reasonable fit to the experimental data. We also found that the presence of as much as 2400 arcsec of external disparity noise does not appear to affect the Dmax threshold. This observation suggests that Dmax is implicated in a mechanism that disregards the disparity variance of individual items, relying instead on the average disparity across all items, supporting the depth model proposed in our previous study (Ding & Levi, 2021), which posits distinct mechanisms governing Dmin and Dmax thresholds.

A polymetric approach for measuring brain activity and behavior: Considerations for gait, gaze and fNIRS measurements in a 10-m walking of elderly and young adults.

The actual changes in biological and physiological parameters during walking are little understood in multiple aspects. The objective of this paper was to examine and link the disparate measures of motor, vision, and brain activity for elderly and young adults. The participants were 15 elderly adults and 10 young adults. Accelerometry, eye tracking, and prefrontal cortex (PFC) activity in the functional near-infrared spectroscopy (fNIRS) were used to evaluate the participants in a 10-m walking test. The results for the elderly adults were 1) low variabilities of velocity and acceleration along the front-back and up-down axes, 2) a wider gaze range on the right-left axis than the young adults, 3) a high mean PFC activity, and 4) a larger number of high-relation pairs than the young adults for the correlation coefficients of both gait vs. gaze and gait vs. PFC activity. The variabilities of velocity and acceleration, gaze and PFC activity changes for the young adults were selective. Measuring 10-m walking in a polymetric approach may capture some indicators related to physical and cognitive difficulties such as frailty and dementia.

Mapping socio-geographical disparities in the occurrence of teenage maternity in Colombia using multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA)

BackgroundThe prevalence of teenage pregnancy in Colombia is higher than the worldwide average. The identification of socio-geographical disparities might help to prioritize public health interventions.AimTo describe variation in the probability of teenage maternity across geopolitical departments and socio-geographical intersectional strata in Colombia.MethodsA cross-sectional study based on live birth certificates in Colombia. Teenage maternity was defined as a woman giving birth aged 19 or younger. Multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA) was applied using multilevel Poisson and logistic regression. Two different approaches were used: (1) intersectional: using strata defined by the combination of health insurance, region, area of residency, and ethnicity as the second level (2) geographical: using geopolitical departments as the second level. Null, partial, and full models were obtained. General contextual effect (GCE) based on the variance partition coefficient (VPC) was considered as the measure of disparity. Proportional change in variance (PCV) was used to identify the contribution of each variable to the between-strata variation and to identify whether this variation, if any, was due to additive or interaction effects. Residuals were used to identify strata with potential higher-order interactions.ResultsThe prevalence of teenage mothers in Colombia was 18.30% (95% CI 18.20–18.40). The highest prevalence was observed in Vichada, 25.65% (95% CI: 23.71–27.78), and in the stratum containing mothers with Subsidized/Unaffiliated healthcare insurance, Mestizo, Rural area in the Caribbean region, 29.08% (95% CI 28.55–29.61). The VPC from the null model was 1.70% and 9.16% using the geographical and socio-geographical intersectional approaches, respectively. The higher PCV for the intersectional model was attributed to health insurance. Positive and negative interactions of effects were observed.ConclusionDisparities were observed between intersectional socio-geographical strata but not between geo-political departments. Our results indicate that if resources for prevention are limited, using an intersectional socio-geographical approach would be more effective than focusing on geopolitical departments especially when focusing resources on those groups which show the highest prevalence. MAIHDA could potentially be applied to many other health outcomes where resource decisions must be made.

A Comparison of Statistical Methods to Construct Confidence Intervals and Fiducial Intervals for Measures of Health Disparities.

Health disparities are differences in health status across different socioeconomic groups. Classical methods, e.g., the Delta method, have been used to estimate the standard errors of estimated measures of health disparities and to construct confidence intervals for these measures. However, the confidence intervals constructed using the classical methods do not have good coverage properties for situations involving sparse data. In this article, we introduce three new methods to construct fiducial intervals for measures of health disparities based on approximate fiducial quantities. Through a comprehensive simulation study, We compare the empirical coverage properties of the proposed fiducial intervals against two Monte Carlo simulation-based methods-utilizing either a truncated Normal distribution or the Gamma distribution-as well as the classical method. The findings of the simulation study advocate for the adoption of the Monte Carlo simulation-based method with the Gamma distribution when a unified approach is sought for all health disparity measures.

How are socioeconomic inequalities in preterm birth explained by maternal smoking and maternal body mass index: A mediation analysis.

Preterm birth affects between 7% and 8% of births in the UK and is a leading cause of infant mortality and childhood disability. Prevalence of preterm birth has been shown to have significant and consistent socioeconomic inequalities. To estimate how much of the association between socioeconomic status (SES) and gestational age at birth is mediated by maternal smoking status and maternal body mass index (BMI). Retrospective cohort study of a maternity hospital in the UK. The analysis included all singleton live births between April 2009 and March 2020 to mothers 18 years old and over, between 22 weeks and 43 weeks gestation. We estimate two measures of mediation for four low gestational age categories: (i) The proportion eliminated the percentage of the effect of SES on low gestational age at birth that would be eliminated by removing the mediators, through the Controlled Direct Effects estimated using serial log-binomial regressions; and (ii) The proportion mediated is the percentage of the effect removed by equalising the distribution of the mediators across socioeconomic groups, estimated using Interventional Disparity Measures calculated through Monte Carlo simulations. Overall, 81,219 births were included, with 63.7% low SES. The risk of extremely (0.3% of all births), very (0.7%) and moderately preterm birth (6.3%) was 1.71 (95% Confidence Interval [CI] 1.29, 2.31), 1.43 (95% CI 1.18, 1.73) and 1.26 (95% CI 1.19, 1.34) times higher in the low SES, compared to higher SES respectively. The proportion of this inequality eliminated by removing both maternal smoking and BMI was 43.4% for moderately preterm births. The proportion mediated for smoking was 33.9%, 43.0% and 48.4% respectively. Smoking during pregnancy is a key mediator of inequalities in preterm birth, representing an area for local action to reduce social inequalities in preterm birth.

Measurement of Higher Education Competitiveness Level and Regional Disparities in China from the Perspective of Sustainable Development

Measurement of Higher Education Competitiveness Level and Regional Disparities in China from the Perspective of Sustainable Development

Measurement of Financial Inclusion Disparity Among Indian States: An Empirical Study using Wroclaw Taxonomic Methodology

Financial inclusion is an essential aspect of economic growth. A well-designed financial system significantly aids in the development of a nation, encourages individuals to save, combats poverty and lessens inequality. Finance inclusion is usually accepted as the primary gauge for the expansion of any economic activity. Therefore, this article aims to provide more exhaustive insight into the performance of financial inclusion at the sub-national level in India. The study has adopted the Wroclaw taxonomic method for developing the composite index of financial inclusion in India, covering the period from 2012 to 2022. The Financial Inclusion Index (FII) is a multi-dimensional phenomenal index that measures many aspects of financial inclusion on a scale from zero to one, where “zero” represents total financial exclusion and “one” means complete financial inclusion in an economy. The results show that Chandigarh is ranked 1st out of the 34 states and UTs with an FII value of 0.09. Bihar has the lowest FII score of 0.75, placing it at 34th in India. The current study will assist the policymakers, government and Reserve Bank of India in formulating policies on financial inclusion in India.

Sense of Purpose in Life Predicts Reduced Risk for and Delayed Onset of Mild Cognitive Impairment: A Multistate Survival Model

AbstractBackgroundWith no known cure for Alzheimer’s disease and related dementias, delaying the onset of cognitive decline represents a key target for future dementia research. Sense of purpose has been shown to be associated with high cognitive functioning, more supportive social ties, and greater intellectual activity, and may be valuable for mitigating cognitive impairment both before and following its onset.MethodLongitudinal data from the Health and Retirement Study (HRS, n = 10,542) and the Rush Memory and Aging Project (MAP, n = 10.48) were used to examine associations between sense of purpose and prospective transitions across normal cognition, mild cognitive impairment (MCI), dementia, and death over up to 12 and 19 years, respectively. Multistate survival modeling examined the impact of sense of purpose on risk for each transition, adjusting for age, sex, education, apolipoprotein‐E allele, and depressive symptoms. Multinomial regression was used to estimate life expectancy in each cognitive state.ResultMore purposeful older adults were found to have lower prospective risk of developing MCI in the HRS (HR = 0.93, 95% CI: 0.90, 0.97) and MAP (HR = 0.82, 95% CI: 0.69, 0.98) and had increased likelihood of improvement in cognitive functioning following MCI classification. In both samples, those higher in sense of purpose were found to have significantly longer overall life expectancy and life expectancy free of cognitive impairment (without MCI or dementia).ConclusionOlder adults higher in sense of purpose appear to live longer lives, with these differences in life expectancy attributable to increases in years lived without cognitive impairment. Replication of findings across longitudinal studies with disparate samples and measurement procedures provides robust support that having a strong sense of purpose in life contributes to cognitive reserve and resilience. Interventions aiming to promote older adult sense of purpose could extend the cognitive healthspan—the period in which individuals live in a cognitively healthy state free of impairment.

An Interplay between Health Equity and Disparity in Cognitive Decline

AbstractBackgroundCognitive decline may be an early indicator of Alzheimer diseases and related dementia (ADRD). To identify the intervention targets that ameliorate disparities in ADRD, it is critical to employ disparity measures that account for health equity. We aimed to investigate disparity estimates in cognitive decline built on three health equity measures.MethodThe study sample (n = 451) was derived from the bi‐ethnic community‐dwelling San Antonio Longitudinal Study of Aging (SALSA). The latent variable mixture model classified cognitive function trajectory strata based on four repeated measures of the Mini Mental Status Examination (MMSE) over 8.5±1.3 years of follow‐up. Three risk adjustments were employed to optimize equity in social determinants of health (SDoH: income, education, social interactions) between Hispanics and non‐Hispanics. 1) Average constrained regression adjustment minimized the impact of SDoH for Hispanics. 2) Covariance constrained adjustment derived estimates with a near independence between the residuals with ethnicity. 3) Net compensation penalized regression imposed a penalty for excess lower MMSE among Hispanics. Inverse propensity score weighting (IPSW) estimates of disparity further adjusted away confounding due to covariates (demographics, disease burdens) between ethnic groups.ResultTable 1 contrasted baseline characteristics of the study sample between Hispanics and non‐Hispanics. Two MMSE trajectory strata were identified: cognitive decline stratum (38%) with mean MMSE decreased from 23.9 to 21.2; and stable cognitive function stratum (62%) with mean MMSE around 28 throughout. Average constrained and covariance constrained risk adjustments attained optimal SDoH equity across three fairness metrics: predictive ratios, fair covariance, and net compensation (Table 2). Ethnic disparity in cognitive decline (Table 3) was strong conditioned on SDoH equity alone (log(aOR) = 4.27, p<0.001). Balancing covariates alone via IPSW without equity in SDoH also fell short for parity (aOR = 1.16, p<0.001). Parity in cognitive decline could be achievable under both SDoH equity and balanced covariates between ethnic groups (aOR = 0.85, p = 0.21).ConclusionOur study suggested that integrating equity metrices in ADRD disparity research could guide the paths to improve equity and reduce disparity. The field would be better served by identifying the causal drivers of disparities through the advancement in equity metrices and mediation analyses that delineate intricate interactions between SDoH and ADRD risk factors.

Decomposing the Black-White Racial Disparity in Severe Maternal Morbidity Risk: The Role of Hypertensive Disorders of Pregnancy.

To our knowledge, no studies have explicitly studied the role of hypertensive disorders of pregnancy (HDP) in racial disparities in severe maternal morbidity (SMM). Using causal mediation models, we estimated the proportion of the non-Hispanic (NH) Black-White racial disparity in risk of SMM that is explained through the pathway of HDP. We linked 2006-2019 Georgia hospital discharge records with vital statistics birth and fetal death records for NH Black and NH White birthing persons. We used G-estimation of a structural nested mean model to decompose the absolute racial disparity in the incidence of SMM into pathways operating through HDP. NH Black birthing people experienced an excess 56 SMM events (95% confidence interval [CI] = 52, 59) per 10,000 delivery hospitalizations compared with NH White birthing people. If counterfactual disparity measure estimation assumptions hold, the estimated absolute disparity remaining after blocking the causal pathways through HDP was 41 SMM events per 10,000 deliveries (95% CI = 38, 44), suggesting that 26% (95% CI = 12, 40) of the absolute racial disparity would be eliminated if there was no contribution of HDP to SMM risk. Our results are consistent with the hypothesis that intervening to prevent HDP is an important (yet incomplete) pathway for reducing the excess risk among NH Black pregnancies compared with NH White pregnancies.

The Importance of Equity Value Judgments and Estimator-Estimand Alignment in Measuring Disparity and Identifying Targets to Reduce Disparity.

The choice of which covariates to adjust for (so-called allowability designation (AD)) in health disparity measurements reflects value judgments about inequitable versus equitable sources of health differences, which is paramount for making inferences about disparity. Yet, many off-the-shelf estimators used in health disparity research are not designed with equity considerations in mind, and they imply different ADs. We demonstrated the practical importance of incorporating equity concerns in disparity measurements through simulations, motivated by the example of reducing racial disparities in hypertension control via interventions on disparities in treatment intensification. Seven causal decomposition estimators, each with a particular AD (with respect to disparities in hypertension control and treatment intensification), were considered to estimate the observed outcome disparity and the reduced/residual disparity under the intervention. We explored the implications for bias of the mismatch between equity concerns and the AD in the estimator under various causal structures (through altering racial differences in covariates or the confounding mechanism). The estimator that correctly reflects equity concerns performed well under all scenarios considered, whereas the other estimators were shown to have the risk of yielding large biases in certain scenarios, depending on the interaction between their ADs and the specific causal structure.

Self-Training Reinforced Adversarial Adaptation for Machine Fault Diagnosis

To alleviate the predicament of data annotating and the need for collecting data from identical distribution, unsupervised domain adaptation technologies have been widely deployed in the field of machine fault diagnosis. Nevertheless, most of them focus only on domain alignment and fail to make full use of the unlabeled target data. Given this, a novel Self-training Reinforced Adversarial Adaptation (SRAA) diagnosis method is developed in this study. In SRAA, an adversarial adaptation mechanism based on a bi-classifier disparity measure is introduced to implicitly align two domains. Meanwhile, a bi-classifier-oriented self-training algorithm is further proposed to fully mine the connotation information of unlabeled target data and reinforce model performance, in which an adaptive sample selection strategy and soft cross-entropy loss are included to guide high-confidence self-training. Empirical evidence from extensive experiments demonstrates the efficacy of SRAA, and comprehensive comparisons against the existing approaches show the superiority of our method.

Coarse-to-fine interaction on perceived depth in compound grating.

To encode binocular disparity, the visual system uses a pair of left eye and right eye bandpass filters with either a position or a phase offset between them. Such pairs are considered to exit at multiple scales to encode a wide range of disparity. However, local disparity measurements by bandpass mechanisms can be ambiguous, particularly when the actual disparity is larger than a half-cycle of the preferred spatial frequency of the filter, which often occurs in fine scales. In this study, we investigated whether the visual system uses a coarse-to-fine interaction to resolve this ambiguity at finer scales for depth estimation from disparity. The stimuli were stereo grating patches composed of a target and comparison patterns. The target patterns contained spatial frequencies of 1 and 4 cycles per degree (cpd). The phase disparity of the low-frequency component was 0° (at the horopter), -90° (uncrossed), or 90° (crossed), and that of the high-frequency components was changed independent of the low-frequency disparity, in the range between -90° (uncrossed) and 90° (crossed). The observers' task was to indicate whether the target appeared closer to the comparison pattern, which always shared the disparity with the low-frequency component of the target. Regardless of whether the comparison pattern was a 1-cpd + 4-cpd compound or a 1-cpd simple grating, the perceived depth order of the target and the comparison varied in accordance with the phase disparity of the high-frequency component of the target. This effect occurred not only when the low-frequency component was at the horopter, but also when it contained a large disparity corresponding to one cycle of the high-frequency component (±90°). Our findings suggest a coarse-to-fine interaction in multiscale disparity processing, in which the depth interpretation of the high-frequency changes based on the disparity of the low-frequency component.

Health, Longevity, and Welfare Inequality of Older Americans

Abstract We estimate the distribution of well-being among the older U.S. population using an expected utility framework that incorporates differences in consumption, leisure, health, and mortality. We find large disparities in welfare that have increased over time. Incorporating the cost of living with poor health into elderly welfare substantially increases the overall inequality. Disparity measures based on cross-sectional income or consumption underestimate the growth in aggregate welfare inequality. Moreover, health is a better indicator of an individual's relative welfare position than income or consumption.

Consistency of the PRL Across Vergence Demand as a Measure of Objective Fixation Disparity

Consistency of the PRL Across Vergence Demand as a Measure of Objective Fixation Disparity

A microbial causal mediation analytic tool for health disparity and applications in body mass index

BackgroundEmerging evidence suggests the potential mediating role of microbiome in health disparities. However, no analytic framework can be directly used to analyze microbiome as a mediator between health disparity and clinical outcome, due to the non-manipulable nature of the exposure and the unique structure of microbiome data, including high dimensionality, sparsity, and compositionality.MethodsConsidering the modifiable and quantitative features of the microbiome, we propose a microbial causal mediation model framework, SparseMCMM_HD, to uncover the mediating role of microbiome in health disparities, by depicting a plausible path from a non-manipulable exposure (e.g., ethnicity or region) to the outcome through the microbiome. The proposed SparseMCMM_HD rigorously defines and quantifies the manipulable disparity measure that would be eliminated by equalizing microbiome profiles between comparison and reference groups and innovatively and successfully extends the existing microbial mediation methods, which are originally proposed under potential outcome or counterfactual outcome study design, to address health disparities.ResultsThrough three body mass index (BMI) studies selected from the curatedMetagenomicData 3.4.2 package and the American gut project: China vs. USA, China vs. UK, and Asian or Pacific Islander (API) vs. Caucasian, we exhibit the utility of the proposed SparseMCMM_HD framework for investigating the microbiome’s contributions in health disparities. Specifically, BMI exhibits disparities and microbial community diversities are significantly distinctive between reference and comparison groups in all three applications. By employing SparseMCMM_HD, we illustrate that microbiome plays a crucial role in explaining the disparities in BMI between ethnicities or regions. 20.63%, 33.09%, and 25.71% of the overall disparity in BMI in China-USA, China-UK, and API-Caucasian comparisons, respectively, would be eliminated if the between-group microbiome profiles were equalized; and 15, 18, and 16 species are identified to play the mediating role respectively.ConclusionsThe proposed SparseMCMM_HD is an effective and validated tool to elucidate the mediating role of microbiome in health disparity. Three BMI applications shed light on the utility of microbiome in reducing BMI disparity by manipulating microbial profiles.6ppc1U8Yu1nT7JqzesB9dWVideo

Racial/ethnic disparities in estimated undiagnosed HIV infection among adolescents and adults in the United States, 2017-2021.

In 2021, there were an estimated 153 500 persons aged at least 13 years with undiagnosed HIV infection. Estimated rates among Black/African American, Hispanic/Latino, and White persons were used to assess disparity trends from 2017 to 2021. Rates decreased across two absolute and relative disparity measures. Despite these declines, Black and Hispanic persons had rates 8.3 and 4.2 times the rate of White persons in 2021. Increased testing and innovative efforts are needed to address HIV-related disparities.

Topical Review: Methodological Variables in Clinical and Laboratory Measurements of Fixation Disparity.

Fixation disparity is a small vergence error that does not disrupt fusion. Fixation disparity measures correlate with binocular symptoms. This article covers methodological differences between clinical fixation disparity measurement devices, findings when objective and subjective fixation disparities are compared, and the potential impact of binocular capture on fixation disparity measurements. Fixation disparity is a small vergence error that occurs in nonstrabismic individuals and does not disrupt fusion. This article reviews clinical fixation disparity variables and their clinical diagnostic value. Clinical devices that are used to measure these variables are described, as are studies in which the output from these devices has been compared. Methodological differences between the devices such as the location of the fusional stimulus, the rate at which judgments of dichoptic alignment are made, and the strength of the accommodative stimulus are all considered. In addition, the article covers theories of the neural origins of fixation disparity and control system models incorporating fixation disparity. Studies in which objective fixation disparities (oculomotor portion of fixation disparity assessed with an eye tracker) and subjective fixation disparities (sensory portion of fixation disparity assessed psychophysically with dichoptic Nonius lines) have been compared are also examined, and consideration is given to why some investigators find differences in these measures, whereas other investigators do not. The conclusion thus far is that there are likely complex interactions between vergence adaptation, accommodation, and the location of the fusional stimulus that lead to differences in objective and subjective fixation disparity measures. Finally, capture of the visual direction of monocular stimuli by adjacent fusional stimuli and the implications for fixation disparity measures are considered.