Tag: medicine

Coronavirus and race

Coronavirus and race

Doing some thinking about whether or not we can estimate the effect of ethnicity on outcomes for coronavirus. There’s a nice discussion on the use of race/ethnicity and causal inference on CrossValidated.

The key message is that because race is not modifiable then it doesn’t make sense to think of it in terms of a causal pathway. Causal effects imply an action: a drug treats a treats a disease. Giving that same drug to another person, one would expect a similar effect. We cannot ‘give’ race to another person, so we can’t say that race causes a disease. In the same way, we cannot make someone older, or female, or blonde. These are not factors that we control, and therefore they do not cause an outcome.

This does not mean that that outcomes cannot differ for different racial groups. Here we are interested in the predictive effect not the causal effect. And here the challenge is distinguishing whether race is mediated via genetics or via its social and economic consequences.

With respect to COVID19, the specific question of interest is whether there is a genetic predisposition to worse outcomes amongst BAME (Black, Asian and Minority Ethnic groups). Or whether this is entirely mediated through the associated social and economic factors.

Also see

VanderWeele TJ, Robinson WR (2014) On the causal interpretation of race in regressions adjusting for confounding and mediating variables. Epidemiology 25: 473-484.