Research / BFI Working PaperMay 18, 2023

Representation and Hesitancy in Population Health Research: Evidence from a COVID-19 Antibody Study

Deniz Dutz, Michael Greenstone, Ali Hortaçsu, Santiago Lacouture, Magne Mogstad, Azeem Shaikh, Alexander Torgovitsky, Winnie van Dijk

We examine why minority and poor households are often underrepresented in studies that require active participation. Using data from a serological study with randomized participation incentives, we find large participation gaps by race and income when incentives are low, but not when incentives are high. We develop a framework for using randomized incentives to disentangle the roles of hesitancy and non-contact in driving the participation gaps, and find that hesitancy is the predominant factor. Hesitancy rates strongly correlate with hospitalization rates and COVID-19 risk, suggesting that individuals facing higher health risks may be underrepresented in studies with low incentives.

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