Social Determinants of Health and Racial Disparities in Lung Function: Findings from the National Health and Nutrition Examination Survey, 2007–2012
Bibliographic record
Abstract
Abstract Rationale We hypothesized that the disproportionate impact of social determinants of health (SDoH) captured in survey data could help explain a larger proportion of racial gaps in lung function than previously reported. Objective To estimate the contribution of SDoH to racial gaps in lung function. Methods We defined a series of nested, increasingly healthy reference populations using data from the National Health and Nutrition Examination Survey, 2007–2012. Starting with nonsmokers without respiratory symptoms or diagnoses, we sequentially excluded those with confirmed occupational exposure to dust and/or fumes, physical inactivity, maternal or secondhand tobacco use, obesity, no home ownership, no insurance, lower education, and self-reported unhealthy diet. Across successive populations, we compared average age-, sex-, and height-adjusted differences in FEV1 and FVC between racial and ethnic minority groups and non-Hispanic White participants for adults (aged ≥20 yr) and children (aged 6–19 yr). Measurements and Main Results In successively healthier reference populations, the proportion of represented participants declined for non-Hispanic Black, Mexican American, and other Hispanic participants; increased for non-Hispanic White participants; and remained stable for non-Hispanic Asian participants. At baseline, adjusted FEV1 and FVC were similar for Mexican American and non-Hispanic White American participants but lower for other racial and ethnic minority groups. After excluding individuals with unfavorable SDoH, racial disparities in FEV1 and FVC decreased for non-Hispanic Black children (24.8% and 26.2%) and adults (26.3% and 19.4%), other Hispanic children (15.2% and 19.3%) and adults (85.9% and 12.4%), and non-Hispanic Asian children (6.6% and 12.5%), but they increased for non-Hispanic Asian adults (14.1% and 11.1%). Conclusions Unfavorable SDoH disproportionately affected non-Hispanic Black, Mexican American, and other Hispanic populations and explained a higher proportion of racial disparities in lung function than previously reported.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".