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ABSTRACT Disparities in health or well‐being experienced by minority groups can be difficult to study using the traditional exposure‐outcome paradigm in causal inference, since potential outcomes in variables such as race or sexual minority status are challenging to interpret. Causal decomposition analysis addresses this gap by positing causal effects on disparities under interventions to other intervenable exposures that may play a mediating role in the disparity. While invoking weaker assumptions than causal mediation approaches, decomposition analyses are often conducted in observational settings and require uncheckable assumptions that eliminate unmeasured confounders. Leveraging the marginal sensitivity model, we develop a sensitivity analysis for weighted causal decomposition estimators and use the percentile bootstrap to construct valid confidence intervals for causal effects on disparities. We also propose a two‐parameter reformulation that enhances interpretability and facilitates an intuitive understanding of the plausibility of unmeasured confounders and their effects. We illustrate our framework on a study examining the effect of parental support on disparities in suicidal ideation among sexual minority youth. We find that the effect is small and sensitive to unmeasured confounding, suggesting that further screening studies are needed to identify mitigating interventions in this vulnerable population.
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Causal Decomposition Analysis With Time-Varying Mediators: Designing Individualized Interventions to Reduce Social Disparities
Causal decomposition analysis aims to identify risk factors (referred to as “mediators”) that contribute to social disparities in an outcome. Despite promising developments in causal decomposition analysis, current methods are limited to addressing a time-fixed mediator and outcome only, which has restricted our understanding of the causal mechanisms underlying social disparities. In particular, existing approaches largely overlook individual characteristics when designing (hypothetical) interventions to reduce disparities. To address this issue, we extend current longitudinal mediation approaches to the context of disparities research. Specifically, we develop a novel decomposition analysis method that addresses individual characteristics by (a) using optimal dynamic treatment regimes (DTRs) and (b) conditioning on a selective set of individual characteristics. Incorporating optimal DTRs into the design of interventions can be used to strike a balance between equity (reducing disparities) and excellence (improving individuals’ outcomes). We illustrate the proposed method using the High School Longitudinal Study data.
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- Award ID(s):
- 2243119
- PAR ID:
- 10526957
- Publisher / Repository:
- SAGE Publications
- Date Published:
- Journal Name:
- Sociological Methods & Research
- ISSN:
- 0049-1241
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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