Issues and methods in disparities research: the Rhode Island-Puerto Rico asthma center.
BACKGROUND
Epidemiologic studies have documented higher rates of asthma prevalence and morbidity in minority children compared to non-Latino white (NLW) children. Few studies focus on the mechanisms involved in explaining this disparity, and fewer still on the methodological challenges involved in rigorous disparities research.


OBJECTIVE
This article provides an overview of challenges and potential solutions to research design for studies of health disparities. The methodological issues described in this article were framed on an empirical model of asthma health disparities that views disparities as resulting from several factors related to the healthcare system and the individual/community system. The methods used in the Rhode Island-Puerto Rico Asthma Center are provided as examples, illustrating the challenges in executing disparities research.


RESULTS
Several methods are described: distinguishing ethnic/racial differences from methodological artifacts, identifying and adapting culturally sensitive measures to explain disparities, and addressing the challenges involved in determining asthma and its severity in Latino and other minority children. The measures employed are framed within each of the components of the conceptual model presented.


CONCLUSIONS
Understanding ethnic and/or cultural disparities in asthma morbidity is a complicated process. Methodologic approaches to studying the problem must reflect this complexity, allowing us to move from documenting disparities to understanding them, and ultimately to reducing them.
Canino
Glorisa
G
Behavioral Sciences Research Institute, University of Puerto Rico School of Medicine, San Juan, Puerto Rico. glorisa.canino@upr.edu
McQuaid
Elizabeth L
EL
Alvarez
Maria
M
Colon
Angel
A
Esteban
Cynthia
C
Febo
Vivian
V
Klein
Robert B
RB
Mitchell
Daphne Koinis
DK
Kopel
Sheryl J
SJ
Montealegre
Federico
F
Ortega
Alexander N
AN
Rodriguez-Santana
Jose
J
Seifer
Ronald
R
Fritz
Gregory K
GK
D001249:Asthma / Q000208:ethnology*; D003431:Cross-Cultural Comparison; D054624:Health Status Disparities; D006630:Hispanic or Latino; D006801:Humans; D012107:Research Design; D012237:Rhode Island