美国的一般自我效能与死亡率：种族差异。
General Self-Efficacy and Mortality in the USA; Racial Differences.
机构信息
Department of Psychiatry, University of Michigan, 4250 Plymouth Road, SPC 5763, Ann Arbor, MI, 48109-2700, USA.
Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
出版信息
J Racial Ethn Health Disparities. 2017 Aug;4(4):746-757. doi: 10.1007/s40615-016-0278-0. Epub 2016 Oct 12.
PURPOSE
General self-efficacy has been historically assumed to have universal health implications. However, less is known about population differences in long-term health effects of general self-efficacy across diverse populations. This study compared black and white American adults for (1) the association between psychosocial and health factors and general self-efficacy at baseline, and (2) the association between baseline self-efficacy and long-term risk of all-cause mortality over 25 years.
METHODS
The Americans' Changing Lives (ACL) study, 1986-2011, is a nationally representative longitudinal cohort of US adults. The study followed 3361 black (n = 1156) and white (n = 2205) adults for up to 25 years. General self-efficacy as well as demographics, socioeconomics, stressful life events, health behaviors, obesity, depressive symptoms, and self-rated health were measured at baseline in 1986. The outcome was time to all-cause mortality since 1986. Race was the focal moderator. Logistic regression and proportional hazards models were used for data analysis.
RESULTS
Although blacks had lower general self-efficacy, this association was fully explained by socioeconomic factors (education and income). Our logistic regression suggested interactions between race and education, self-rated health, and stress on general self-efficacy at baseline. Baseline general self-efficacy was associated with risk of mortality in the pooled sample. Race interacted with baseline general self-efficacy on mortality risk, suggesting stronger association for whites than blacks.
CONCLUSION
Black-white differences exist in psychosocial and health factors associated with self-efficacy in the USA. Low general self-efficacy does not increase mortality risk for blacks. Future research should test whether socioeconomic status, race-related attitudes, world views, attributions, and locus of control can potentially explain why low self-efficacy is not associated with higher risk of mortality among American blacks.
目的
一般自我效能感一直被认为对健康具有普遍影响。然而，对于不同人群中一般自我效能感对长期健康影响的人群差异知之甚少。本研究比较了美国黑人和白人成年人，（1）在基线时，心理社会因素和健康因素与一般自我效能感之间的关系，以及（2）基线时自我效能感与 25 年内全因死亡率的长期风险之间的关系。
方法
1986 年至 2011 年的美国人生活变化（ACL）研究是一项具有全国代表性的美国成年人纵向队列研究。该研究对 3361 名黑人（n=1156）和白人（n=2205）成年人进行了长达 25 年的随访。1986 年基线时测量了一般自我效能感以及人口统计学、社会经济、生活压力事件、健康行为、肥胖、抑郁症状和自我报告的健康状况。结局是自 1986 年以来的全因死亡率。种族是焦点调节变量。逻辑回归和比例风险模型用于数据分析。
结果
尽管黑人的一般自我效能感较低，但这种关联完全可以通过社会经济因素（教育和收入）来解释。我们的逻辑回归表明，种族与教育、自我报告的健康状况和基线时的压力之间存在交互作用。基线时的一般自我效能感与总体死亡率风险相关。种族与基线时的一般自我效能感对死亡率风险存在交互作用，表明白人的相关性强于黑人。
结论
在美国，与自我效能感相关的心理社会因素和健康因素存在黑人和白人之间的差异。低一般自我效能感不会增加黑人的死亡风险。未来的研究应该检验社会经济地位、与种族有关的态度、世界观、归因和控制源是否可以解释为什么低自我效能感与美国黑人更高的死亡率风险无关。
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