Justice-Informed Analysis: A Unified Framework for Increasing Inclusivity and Methodological Rigor in Health Inequities Research

OBJECTIVES: We introduce and illustrate a new application of a justice-informed approach to analysis and reporting in health disparities research. Our novel approach is designed to provide a unified process for conducting health disparities research with high methodological rigor.

METHODS: We reviewed literature from multiple disciplines to ascertain historical and modern understandings of the justice principle. From this, we developed a new Justice-Informed Analysis framework. To empirically demonstrate our framework, we applied it to a study of early buprenorphine discontinuations.

RESULTS: Justice-informed analysis places responsibility on researchers to adapt processes that account for marginalization and ensure study participants receive access to the benefits of the study’s findings. This approach strives to center the patient experience to set research priorities and incorporate their knowledge in research, address intersectionality of minoritized identities, and identify the cause of disparities. By contrast, most existing health disparities research is guided by approaches characterized by documenting and explaining gaps in health outcomes, with the emphasis on the research question rather than the continuum of the research process. Existing methodological best-practices to mitigate bias (e.g., using directed acyclic graphs to guide modeling decisions) and communicate results clearly (e.g., using marginal effects) are essential tools within this framework. We successfully applied the framework to a pre-existing study of early buprenorphine discontinuations, using justice-informed methods to report on disparities more equitably across a range of marginalizations.

CONCLUSIONS: Grounded in the long-standing principle of justice, the Justice-Informed Analysis framework provides researchers with guidance for approaching all phases of the research process, from specification of the research question to presentation of results. It is imperative that we continue to improve practices in health disparities research to gather more accurate, robust data and adopt practices that recognize the experiences of minoritized populations and better identify the root causes of health inequities.