270916 Gardener's Tale Plot: A two-part data display for untangling race/ethnicity, social class, and health

Sunday, October 28, 2012

Camara Jones, MD, MPH, PhD , Epidemiology and Analysis Program Office, Centers for Disease Control and Prevention, Atlanta, GA
We introduce the Gardener's Tale Plot (GTP), a two-part data display which goes beyond summary data on racial/ethnic health disparities to enable simultaneous assessment of the: 1) dependence of a given health outcome on a given measure of social class, 2) existence of racial/ethnic differences in the health outcome within each level of the social class measure, 3) trends in racial/ethnic differences in the health outcome across levels of the social class measure, and 4) relative under- or over-representation of different racial/ethnic groups at different levels of the social class measure.

The GTP comprises two related plots, one placed above the other on a page. The top plot displays the social class measure on the x-axis and the health outcome of interest on the y-axis, with separate data points plotted onto the graph for each race/ethnicity. The bottom plot is a bar graph with the same social class measure on the x-axis and a scale from 0 to 100% on the y-axis, where the height of each bar shows the percent of the population in that social class stratum from a specified racial/ethnic group. A reference line is drawn across the bar graph at the level the specified racial/ethnic group represents in the total population.

The GTP enables understanding of disparities in health outcomes by both race/ethnicity and social class, as well as depiction of the contribution of racial/ethnic differentials in social class to health disparities.

Examples using 2010 BRFSS data on body mass index, education level, and Black, White, and Hispanic race/ethnicity are provided.

Learning Areas:
Public health or related research
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Describe the construction of the Gardenerís Tale Plot. Identify the uses of the Gardenerís Tale Plot for untangling race/ethnicity, social class, and health.

Keywords: Methodology, Social Inequalities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a social epidemiologist and methodologist who developed the Projection Methods for the pairwise comparison of continuous distributions. I am very creative with graphical displays, and have developed the Gardener's Tale Plot as a way of "exploding" summary statistics on racial/ethnic health disparities onto two related plots to disentangle relationships between race/ethnicity, social class, and health. I am also the recipient of the 2011 John Snow Award conferred by the Epidemiology Section of APHA.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.