Bzostek Sharon, Sastry Narayan, Goldman Noreen, Pebley Anne, Duffy Denise
Rutgers University, USA.
University of Michigan, USA.
Soc Sci Med. 2016 Jan;149:46-65. doi: 10.1016/j.socscimed.2015.11.031. Epub 2015 Dec 2.
Researchers often rely on respondents' self-rated health (SRH) to measure social disparities in health, but recent studies suggest that systematically different reporting styles across groups can yield misleading conclusions about disparities in SRH. In this study, we test whether this finding extends to ethnic differences in self-assessments of health in particular domains. We document differences between US-born whites and four Latino subgroups in respondents' assessments of health in six health domains using data from the second wave of the Los Angeles Family and Neighborhood Survey (N = 1468). We use both conventional methods and an approach that uses vignettes to adjust for differential reporting styles. Our results suggest that despite consistent evidence from the literature that Latinos tend to rate their overall health more poorly than whites, and that Latino immigrants report worse SRH than US-born Latinos, this pattern is not true of self-reports in individual health domains. We find that at the bivariate level, US-born whites (and often US-born Mexicans) have significantly more pessimistic reporting styles than Latino immigrants. After adding controls, we find evidence of significantly different reporting styles for only one domain: US-born Mexicans and whites consistently interpret head pain more severely than the other Latino subgroups. Finally, we find that both before and after adjusting for differences in rating styles across groups, non-Mexican Latino immigrants report better social and physical functioning and less pain than other groups. Our findings underscore the advantages of domain-specific ratings when evaluating ethnic differences in self-assessments of health. We encourage researchers studying social disparities in health to consider respondents' self-assessments in a variety of domains, and to also investigate (when possible) potential biases in their findings due to different reporting styles. The anchoring vignettes approach we use is one potential method for overcoming biases due to different rating styles across groups.
研究人员常常依靠受访者的自评健康状况（SRH）来衡量健康方面的社会差异，但最近的研究表明，不同群体间存在系统性差异的报告方式可能会得出有关SRH差异的误导性结论。在本研究中，我们测试这一发现是否尤其适用于特定领域健康自评中的种族差异。我们利用洛杉矶家庭与邻里调查第二轮的数据（N = 1468），记录了在美国出生的白人与四个拉丁裔亚群体在六个健康领域的健康自评差异。我们既使用了传统方法，也采用了一种利用 vignettes 来调整不同报告方式的方法。我们的结果表明，尽管文献中有一致的证据表明拉丁裔往往比白人对自身总体健康的评价更低，且拉丁裔移民报告的SRH比在美国出生的拉丁裔更差，但在个体健康领域的自我报告中并非如此。我们发现，在双变量层面，在美国出生的白人（以及通常在美国出生的墨西哥人）的报告方式比拉丁裔移民明显更悲观。加入控制变量后，我们发现只有一个领域存在明显不同的报告方式：在美国出生的墨西哥人和白人对头痛的解读始终比其他拉丁裔亚群体更严重。最后，我们发现，在调整了不同群体评分方式的差异前后，非墨西哥裔拉丁裔移民报告的社会和身体功能更好，疼痛更少。我们的研究结果强调了在评估健康自评中的种族差异时特定领域评分的优势。我们鼓励研究健康方面社会差异的研究人员考虑受访者在多个领域的自我评估，并（在可能的情况下）调查其研究结果中因不同报告方式而可能存在的偏差。我们使用的锚定 vignettes 方法是克服因不同群体评分方式导致的偏差的一种潜在方法。
