Exploring differences in self-rated health among Blacks, Whites, Mexicans, and Puerto Ricans (original) (raw)
Related papers
Validity of Self-rated Health among Latino(a)s
American Journal of Epidemiology, 2002
The authors investigated whether self-rated health (SRH) had differential mortality risks for Latino(a) adults of various acculturation statuses living in the United States. They used cumulative National Health Interview Survey data from 1989 to 1994 (n = 37,713) linked with the National Health Interview Survey Multiple Cause of Death data files (1,364 deaths) that match records from the National Death Index through 1997. The authors specified survival models to estimate the effect of SRH on mortality and further stratified their model by birth and duration in the United States as proxies for acculturation. These estimates were compared across strata. Poor SRH was found to be a weaker predictor of subsequent mortality risk among the less acculturated, although the overall risk among the aggregated sample is similar to the risk reported in previous studies. The relation between poor SRH and mortality risk increases with United States acculturation among Latinos. While poor SRH was significantly associated with short-term mortality among the least acculturated, this association did not persist beyond 2-year mortality risk. Health researchers wishing to use SRH to assess the physical health of multiethnic populations should at least control for levels of acculturation among respondents. Am J Epidemiol 2002;155:755-9.
The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 2013
Objectives. Using subsequent all-cause mortality as a yardstick for retrospective health, this study assessed the comparability of self-rated health (SRH) between non-Hispanic whites and Hispanics. Methods. Based on longitudinal data from 6,870 white and 886 Hispanic respondents aged between 51 and 61 in the 1992 Health and Retirement Study, we related SRH in 1992 to risk of mortality in the 1992-2008 period. Logit models were used to predict white-Hispanic differences in reporting fair or poor SRH. Survival curves and cox proportional hazard models were estimated to assess whether and the extent to which the SRH-mortality association differs between non-Hispanic whites and Hispanics. Results. Hispanic respondents reported worse SRH than whites at the baseline, yet they had similar risk of mortality as whites in the 1992-2008 period. Overall, Hispanics rated their health more pessimistically than whites. This was especially the case for Hispanics who rated their health fair or poor at the baseline, whereas their presumed health conditions, as reflected by subsequent risk of mortality, should be considerably better than their white counterparts. Discussion. Health disparities between whites and Hispanics aged between 51 and 61 will be overestimated if the assessment has been solely based on differences in SRH between the two groups. Findings from this study call for caution in relying on SRH to quantify and explain health disparities between non-Hispanic whites and Hispanics in the United States.
Racial differences in self-rated health diminishing from 1972 to 2008
Journal of Behavioral Medicine, 2013
In addition to higher morbidity and mortality, Black adults have reported lower self-rated health than White adults. The purpose of this study was to evaluate the diminishing difference in self-rated health between races from 1972 to 2008. Data from 37,936 participants over a 36-year span of the General Social Survey were used to evaluate the effects of race and time on self-rated health. Results confirmed that Black adults reported significantly worse health than White adults. Overall health was rated slightly better across both groups as time went on (b = .002, P \ .0005). However, this increase in health ratings has slowed, even reversing with a decline in health ratings as of late (b = -.014, P = .001). Significant interactions between race and time indicated that the racial difference on this self-rated health measure has changed over time. The rate of change in the difference has slowed over time (b = -.010, P = .021), suggesting that the reduction in the racial difference in self-rated health may be decelerating.
Self-reported Health Status and Mortality in a Multiethnic US Cohort
American Journal of Epidemiology, 1999
on more than 700,000 cohort participants. Although fewer than 5,000 Native Americans are included in this cohort, the data provide information previously unavailable for this group. Also included are almost 17,000 Asian/Pacific Islanders, over 90,000 blacks, and over 50,000 Hispanics. The authors found strong associations between self-reported health status and both socioeconomic status and subsequent mortality. A self-report of fair or poor health was associated with at least a twofold increased risk of mortality for all racial/ethnic groups. Even after adjustment for socioeconomic status and measures of comorbidity, a significant relation was found between self-reported health status and subsequent mortality. The authors found that self-reported health status is a strong prognostic indicator for subsequent mortality for both genders and all racial/ethnic groups examined. These results emphasize the utility of using simple filter questions in population research. Am J Epidemiol 1999;149:41-6.
Research on Aging, 2013
The present study examined how self-rated health was influenced by sociodemographic characteristics, physical health indicators, and sociocultural resources among four racial/ethnic groups of older adults. The data source was the Survey of Older Floridians, a statewide sample of Whites (n = 503), African Americans (n = 360), Cubans (n = 328), and non-Cuban Hispanics (n = 241) who were age 65 and older. Hierarchical regression models of self-rated health were estimated to explore the direct effects of the predictor variables as well as their interactive roles in each racial/ethnic group. Compared to Whites, racial/ethnic minority older adults rated their health more poorly. Although physical health indicators were significant predictors of self-rated health across all groups, the authors found groupspecific predictors and interactions. Findings show similarities and differences in predictors of self-rated health across diverse racial/ethnic groups and suggest the importance of understanding group-specific factors in efforts to improve older adults' perceived and actual health.
Objectives—Self-rated health (SRH) is an important indicator of overall health, predicting morbidity and mortality. This paper investigates what individuals incorporate into their selfassessments of health and how acculturation plays a part in this assessment. The relationship of acculturation to SRH and whether it moderates the association between indicators of health and SRH is also examined. Design—The paper is based on data from adults in the Boston Puerto Rican Health Study, living in the greater Boston area (n=1357) mean age 57.2 (SD=7.6). We used multiple regression analysis and testing for moderation effects. Results—The strongest predictors of poor self-rated health were the number of existing medical conditions, functional problems, allostatic load and depressive symptoms. Poor self-rated health was also associated with being female, fewer years of education, heavy alcohol use, smoking, poverty, and low emotional support. More acculturated Puerto Rican adults rated their health more positively, which corresponded to better indicators of physical and psychological health. Additionally, acculturation moderated the association between some indicators of morbidity (functional status and depressive symptoms) and self-rated health. Conclusions—Self-assessments of overall health integrate diverse indicators, including psychological symptoms, functional status and objective health indicators such as chronic conditions and allostatic load. However, adults’ assessments of overall health differed by acculturation, which moderated the association between health indicators and SRH. The data suggest that when in poor health, those less acculturated may understate the severity of their health problems when rating their overall health, thus SRH might thus conceal disparities. Using SRH can have implications for assessing health disparities in this population.
Self-Rated Health: Changes, Trajectories, and Their Antecedents Among African Americans
Journal of Aging and Health, 2007
Objective-Little is known about changes in self-rated health (SRH) among African Americans. Method-We examined SRH changes and trajectories among 998 African Americans 49 to 65 years old who we reinterviewed annually for 4 years, using multinomial logistic regression and mixed effect models. Results-Fifty-five percent had the same SRH at baseline and 4 years later, 25% improved, and 20% declined. Over time, men were more likely to report lower SRH levels, individuals with hypertension were less likely to report lower SRH levels, and those with congestive heart failure at baseline were more likely to report higher SRH levels. Lower SRH trajectory intercepts were observed for those with lower socioeconomic status, poorer health habits, disease history, and worse functional status. Those with better cognitive status had higher SRH trajectory intercepts. Discussion-The decline in SRH levels among 49-to 65-year-old African Americans is comparable to that of Whites.
Ethnic Variation in the Association Between Objective and Subjective Health in Older Adults
International journal of travel medicine and global health, 2022
Introduction The link between objective (e.g., number of chronic medical conditions [CMCs]) and subjective (e.g., self-rated health [SRH]) health is well-established in health psychology literature. 1,2 Several national and local studies in community settings have documented an inverse association between number, types of CMCs and individuals' subjective wellbeing. 3 Individuals with heart disease, cancer, asthma, arthritis are at risk of depression, anxiety, poor SRH, and low quality of life. 3 Although the link between subjective and objective health is known, 4-6 this linkage may differ across ethnic groups. 7-14 Different ethnic groups utilize different coping mechanisms to deal with adversities such as CMCs. 15 Although CMCs-SRH is also expected in African American populations, this association is expected to be weaker for African American individuals compared to White individuals. 7-14 However, comparative studies are exclusively limited to those comparing African American and White individuals. We are unaware of any comparative study of African American people that has included a non-White control group. African Americans' health paradox 16,17 can be defined as better subjective health of African American population, despite their worse objective health and other adversities. This phenomenon reflects the resilience of African American populations, particularly older adults who have high number of CMCs. Various scholars have attributed this observation to the growth and flourishing in the presence of adversity. Although this phenomenon is documented repeatedly, 16,17 it is unknown whether the paradox also exists when African Americans are compared with ethnic groups other than Whites. The current study tested the African Americans' health paradox with inclusion of Latinos as the control group. Methods Design and Setting This cross-sectional study was conducted between 2015 and 2020 in low socioeconomic status areas of South Los Angeles. Latino and African American older adults with CMCs were http://ijtmgh.com