Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
Am J Public Health. 2010 Apr 1;100 Suppl 1(Suppl 1):S269-76. doi: 10.2105/AJPH.2009.176180. Epub 2010 Feb 10.
We explored whether and how race shapes perceived health status in patients with type 2 diabetes mellitus and coronary artery disease.
We analyzed self-rated health (fair or poor versus good, very good, or excellent) and associated clinical risk factors among 866 White and 333 Black participants in the Bypass Angioplasty Revascularization Investigation 2 Diabetes trial.
Michigan Neuropathy Screening Instrument scores, regular exercise, and employment were associated with higher self-rated health (P < .05). Blacks were more likely than were Whites to rate their health as fair or poor (adjusted odds ratio [OR] = 1.88; 95% confidence interval [CI] = 1.38, 2.57; P < .001). Among Whites but not Blacks, a clinical history of myocardial infarction (OR = 1.61; 95% CI = 1.12, 2.31; P < .001) and insulin use (OR = 1.62; 95% CI = 1.10, 2.38; P = .01) was associated with a fair or poor rating. A post-high school education was related to poorer self-rated health among Blacks (OR = 1.86; 95% CI = 1.07, 3.24; P < .001).
Symptomatic clinical factors played a proportionally larger role in self-assessment of health among Whites with diabetes and coronary artery disease than among Blacks with the same conditions.
我们探讨种族是否以及如何影响 2 型糖尿病和冠心病患者的健康感知。
我们分析了 Bypass Angioplasty Revascularization Investigation 2 Diabetes 试验中 866 名白人患者和 333 名黑人患者的自我报告健康状况（一般或差与好、很好或极好）和相关临床危险因素。
密歇根神经病变筛查工具评分、定期运动和就业与更高的自我报告健康状况相关（P <.05）。黑人自我报告健康状况一般或差的可能性高于白人（校正比值比 [OR] = 1.88；95%置信区间 [CI] = 1.38，2.57；P <.001）。在白人中，但不在黑人中，心肌梗死病史（OR = 1.61；95% CI = 1.12，2.31；P <.001）和胰岛素使用（OR = 1.62；95% CI = 1.10，2.38；P =.01）与一般或差的评分相关。黑人中，高中后教育与较差的自我报告健康状况相关（OR = 1.86；95% CI = 1.07，3.24；P <.001）。
在患有糖尿病和冠心病的白人中，症状性临床因素在自我评估健康方面的作用比例大于黑人。
