Bayesian Kernel Machine Regression for Social Epidemiologic Research

Background: Little attention has been devoted to framing multiple continuous social variables as a "mixture"for social epidemiologic analysis. We propose using the Bayesian kernel machine regression analytic framework that yields univariate, bivariate, and overall exposure mixture effects. Methods: Using data from the 2023 Survey of Racism and Public Health, we conducted a Bayesian kernel machine regression analysis to study several individual, social, and structural factors as an exposure mixture and their relationships with psychological distress among individuals with at least one police arrest. Factors included racial and economic polarization, neighborhood deprivation, perceived discrimination, police perception, subjective social status, and substance use. We complemented this analysis with a series of unadjusted and adjusted models for each exposure mixture variable. Results: We found that more self-reported discrimination experiences in the past year (posterior inclusion probability = 1.00) and greater substance use (posterior inclusion probability = 1.00) correlated with higher psychological distress. These associations were consistent with the findings from the unadjusted and adjusted linear regression analyses: past year perceived discrimination (unadjusted b = 2.58, 95% confidence interval [CI]: 1.86, 3.30; adjusted b = 2.20, 95% CI: 1.45, 2.94) and substance use (unadjusted b = 2.92, 95% CI: 2.21, 3.62; adjusted b = 2.59, 95% CI: 1.87, 3.31). Conclusion: With the rise of big data and the expansion of variables in long-standing cohort and census studies, novel applications of methods from adjacent disciplines are a step forward in identifying exposure mixture associations in social epidemiology and addressing the health needs of socially vulnerable populations.