Center For Multicultural Mental Health Research, Cambridge Health Alliance and Harvard Medical School, 120 Beacon Street, 4th Floor, Somerville, MA 02143, USA.
Qual Life Res. 2010 Dec;19(10):1529-40. doi: 10.1007/s11136-010-9713-6. Epub 2010 Aug 1.
Limited research in health valuation analyzes samples with high proportions of racial/ethnic minorities within the United States. The primary objective was to explore patterns of health valuation across race/ethnicity using the Collaborative Psychiatric Epidemiology Surveys. A secondary objective was to analyze whether mental health disorder and immigrant status were associated with these estimates.
Health valuation questions using different metrics (time and money) were analyzed. Ordered logit models stratified across poor and moderate health tested differences by race/ethnicity, with mental health disorder and immigrant status as covariates.
Asians in moderate health and Latinos were willing to pay more for health than non-Latino whites. Asians in moderate health were willing to trade more time for health. Latinos in poor health were less willing to trade time and gave disproportionate zero-trade responses. Lifetime history of anxiety disorder was positively associated with both metrics. Immigrant status confounded money valuation for Asians in moderate health, and time valuation for Latinos in poor health.
Health valuation estimates vary across race/ethnicity depending upon the metric. Time valuation scenarios appear less feasible for Latinos in poor health. More research is necessary to understand these differences and the role of immigrant status in health valuation.
在美国,针对健康评估的研究样本中,少数民族所占比例有限。本研究的主要目的是使用合作精神流行病学调查(Collaborative Psychiatric Epidemiology Surveys)来探究不同种族/族裔之间的健康评估模式。次要目的是分析心理健康障碍和移民身份是否与这些评估结果相关。
分析了使用不同指标(时间和金钱)的健康评估问题。对健康状况较差和中等的人群进行了分层有序逻辑回归模型分析,将心理健康障碍和移民身份作为协变量。
健康状况中等的亚裔和拉丁裔比非拉丁裔白人更愿意为健康支付更多的钱。健康状况中等的亚裔愿意用更多的时间来换取健康。健康状况较差的拉丁裔不太愿意用时间来交换,并且给出了不成比例的零交易反应。焦虑障碍的终身病史与两种指标均呈正相关。移民身份混淆了健康状况中等的亚裔对金钱的评估,以及健康状况较差的拉丁裔对时间的评估。
根据指标的不同,健康评估的估计值在不同的种族/族裔之间存在差异。对于健康状况较差的拉丁裔来说,时间评估方案似乎不太可行。需要进一步研究以了解这些差异以及移民身份在健康评估中的作用。