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Do small effects matter more in vulnerable populations? an investigation using Environmental influences on Child Health Outcomes (ECHO) cohorts

Title: Do small effects matter more in vulnerable populations? an investigation using Environmental influences on Child Health Outcomes (ECHO) cohorts
Authors: Peacock, JL; Coto, SD; Rees, JR; Sauzet, O; Jensen, ET; Fichorova, R; Dunlop, AL; Paneth, N; Padula, A; Woodruff, T; Morello-Frosch, R; Trowbridge, J; Goin, D; Maldonado, LE; Niu, Z; Ghassabian, A; Transande, L; Ferrara, A; Croen, LA; Alexeeff, S; Breton, C; Litonjua, A; O’Connor, TG; Lyall, K; Volk, H; Alshawabkeh, A; Manjourides, J; Camargo, CA; Dabelea, D; Hockett, CW; Bendixsen, CG; Hertz-Picciotto, I; Schmidt, RJ; Hipwell, AE; Keenan, K; Karr, C; LeWinn, KZ; Lester, B; Camerota, M; Ganiban, J; McEvoy, C; Elliott, MR; Sathyanarayana, S; Ji, N; Braun, JM; Karagas, MR; Smith, PB; Newby, LK; Jacobson, LP; Catellier, DJ; Gershon, R; Cella, D; Cordero, J; Meeker, J; Gatzke-Kopp, L; Swingler, M; Mansbach, JM; Spergel, JM; Samuels-Kalow, ME; Stevenson, MD; Bauer, CS; Koinis Mitchell, D; Deoni, S; D.’Sa, V; Duarte, CS; Monk, C; Posner, J; Canino, G; Elliott, AJ; Gern, J; Miller, R; Zoratti, E; Seroogy, C; Jackson, D; Bacharier, L; Kattan, M; Wood, R; Rivera-Spoljaric, K; Hershey, G; Hartert, T; Johnson, C; Ownby, D; Singh, A; Bastain, T; Farzan, S; Habre, R; Tylavsky, F; Mason, A; Zhao, Q; Bush, N; Carter, B; Pastyrnak, S; Neal, C; Smith, L; Helderman, J; Leve, L; Neiderhiser, J; Weiss, ST; O.Connor, G; Zeiger, R; Tepper, R; Landa, R; Ozonoff, S; Dager, S; Schultz, R; Piven, J; Simhan, H; Buss, C; Wadhwa, P; Huff, K; Miller, RK; Oken, E; Kerver, JM; Barone, C; Fussman, C; Elliott, M; Ruden, D; Herbstman, J; Schantz, S; Stanford, J; Porucznik, C; Giardino, A; Wright, RJ; Bosquet-Enlow, M; Huddleston, K; Nguyen, R; Barrett, E; Swan, S; Perera, F
Publisher Information: Springer Science and Business Media LLC
Publication Year: 2024
Collection: St George's University of London: Repository
Description: BACKGROUND: A major challenge in epidemiology is knowing when an exposure effect is large enough to be clinically important, in particular how to interpret a difference in mean outcome in unexposed/exposed groups. Where it can be calculated, the proportion/percentage beyond a suitable cut-point is useful in defining individuals at high risk to give a more meaningful outcome. In this simulation study we compute differences in outcome means and proportions that arise from hypothetical small effects in vulnerable sub-populations. METHODS: Data from over 28,000 mother/child pairs belonging to the Environmental influences on Child Health Outcomes Program were used to examine the impact of hypothetical environmental exposures on mean birthweight, and low birthweight (LBW) (birthweight < 2500g). We computed mean birthweight in unexposed/exposed groups by sociodemographic categories (maternal education, health insurance, race, ethnicity) using a range of hypothetical exposure effect sizes. We compared the difference in mean birthweight and the percentage LBW, calculated using a distributional approach. RESULTS: When the hypothetical mean exposure effect was fixed (at 50, 125, 167 or 250g), the absolute difference in % LBW (risk difference) was not constant but varied by socioeconomic categories. The risk differences were greater in sub-populations with the highest baseline percentages LBW: ranging from 3.1-5.3 percentage points for exposure effect of 125g. Similar patterns were seen for other mean exposure sizes simulated. CONCLUSIONS: Vulnerable sub-populations with greater baseline percentages at high risk fare worse when exposed to a small insult compared to the general population. This illustrates another facet of health disparity in vulnerable individuals.
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
ISSN: 1471-2458
Relation: https://openaccess.sgul.ac.uk/id/eprint/118520/2/s12889-024-20075-x.pdf; https://openaccess.sgul.ac.uk/id/eprint/118520/1/12889_2024_20075_MOESM1_ESM.pdf; Peacock, JL; Coto, SD; Rees, JR; Sauzet, O; Jensen, ET; Fichorova, R; Dunlop, AL; Paneth, N; Padula, A; Woodruff, T; et al. Peacock, JL; Coto, SD; Rees, JR; Sauzet, O; Jensen, ET; Fichorova, R; Dunlop, AL; Paneth, N; Padula, A; Woodruff, T; Morello-Frosch, R; Trowbridge, J; Goin, D; Maldonado, LE; Niu, Z; Ghassabian, A; Transande, L; Ferrara, A; Croen, LA; Alexeeff, S; Breton, C; Litonjua, A; O’Connor, TG; Lyall, K; Volk, H; Alshawabkeh, A; Manjourides, J; Camargo, CA; Dabelea, D; Hockett, CW; Bendixsen, CG; Hertz-Picciotto, I; Schmidt, RJ; Hipwell, AE; Keenan, K; Karr, C; LeWinn, KZ; Lester, B; Camerota, M; Ganiban, J; McEvoy, C; Elliott, MR; Sathyanarayana, S; Ji, N; Braun, JM; Karagas, MR; Smith, PB; Newby, LK; Jacobson, LP; Catellier, DJ; Gershon, R; Cella, D; Cordero, J; Meeker, J; Gatzke-Kopp, L; Swingler, M; Mansbach, JM; Spergel, JM; Samuels-Kalow, ME; Stevenson, MD; Bauer, CS; Koinis Mitchell, D; Deoni, S; D.’Sa, V; Duarte, CS; Monk, C; Posner, J; Canino, G; Elliott, AJ; Gern, J; Miller, R; Zoratti, E; Seroogy, C; Jackson, D; Bacharier, L; Kattan, M; Wood, R; Rivera-Spoljaric, K; Hershey, G; Hartert, T; Johnson, C; Ownby, D; Singh, A; Bastain, T; Farzan, S; Habre, R; Tylavsky, F; Mason, A; Zhao, Q; Bush, N; LeWinn, KZ; Carter, B; Pastyrnak, S; Neal, C; Smith, L; Helderman, J; Leve, L; Neiderhiser, J; Weiss, ST; O.Connor, G; Zeiger, R; Tepper, R; Landa, R; Ozonoff, S; Dager, S; Schultz, R; Piven, J; Simhan, H; Buss, C; Wadhwa, P; Huff, K; Miller, RK; Oken, E; Kerver, JM; Barone, C; Fussman, C; Elliott, M; Ruden, D; Herbstman, J; Schantz, S; Stanford, J; Porucznik, C; Giardino, A; Wright, RJ; Bosquet-Enlow, M; Huddleston, K; Nguyen, R; Barrett, E; Swan, S; Perera, F (2024) Do small effects matter more in vulnerable populations? an investigation using Environmental influences on Child Health Outcomes (ECHO) cohorts. BMC Public Health, 24 (1). p. 2655. ISSN 1471-2458 https://doi.org/10.1186/s12889-024-20075-x SGUL Authors: Peacock, Janet Lesley
DOI: 10.1186/s12889-024-20075-x
Availability: https://openaccess.sgul.ac.uk/id/eprint/118520/; https://openaccess.sgul.ac.uk/id/eprint/118520/1/12889_2024_20075_MOESM1_ESM.pdf; https://doi.org/10.1186/s12889-024-20075-x
Rights: cc_by_nc_nd_4
Accession Number: edsbas.2C6DA1E5
Database: BASE