Cobb Sharon, Assari Shervin
School of Nursing, Charles R. Drew University of Medicine and Science, Los Angeles, USA.
Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, USA.
Int J Epidemiol Res. 2020 Winter;7(1):25-34. doi: 10.34172/ijer.2020.05.
According to the sponge hypothesis, compared to men's self-rated health (SRH), women's SRH is more likely to reflect conditions other than chronic medical conditions (CMCs) such as psychiatric disorders (PDs). As a result, poor SRH is a weaker predictive factor for mortality risk for women than men. Most of this literature, however, is done in samples that are predominantly middleclass White. To test the sponge hypothesis among economically disadvantaged African Americans (AAs), this study compared low-income AA men and women for the effects of the number of PDs and CMCs on SRH.
This cross-sectional study recruited a non-random sample (n = 150) of economically disadvantaged AA adults with PD(s). Structured face-to-face interviews were used to collect data. SRH was measured using a single-item measure. PDs and CMCs were also self-reported. We applied linear regression models to test the interactions between SRH and the number of PDs and CMC as well as gender.
The number of PDs and CMCs were associated with SRH in the pooled sample of low-income AA adults with PD(s). However, we found a significant interaction between the number of PDs and gender. This interaction suggested a stronger association between PDs and SRH for AA women than AA men. Gender did not alter the association between the number of CMCs and SRH.
The number of PDs is a determinant of SRH for low-income AA women but not AA men, supporting the sponge hypothesis.
根据“海绵假说”，与男性的自评健康状况（SRH）相比，女性的SRH更有可能反映除慢性疾病（CMCs）之外的状况，如精神疾病（PDs）。因此，与男性相比，SRH较差对女性死亡风险的预测因素较弱。然而，这些文献大多是在以白人中产阶级为主的样本中进行的。为了在经济上处于不利地位的非裔美国人（AAs）中检验“海绵假说”，本研究比较了低收入的非裔美国男性和女性中PDs和CMCs数量对SRH的影响。
本横断面研究招募了150名患有PDs的经济上处于不利地位的非裔美国成年人作为非随机样本。采用结构化面对面访谈收集数据。使用单项测量法测量SRH。PDs和CMCs也通过自我报告获得。我们应用线性回归模型来检验SRH与PDs和CMCs数量以及性别的相互作用。
在患有PDs的低收入非裔美国成年人的汇总样本中，PDs和CMCs的数量与SRH相关。然而，我们发现PDs数量与性别之间存在显著的相互作用。这种相互作用表明，与非裔美国男性相比，非裔美国女性的PDs与SRH之间的关联更强。性别并未改变CMCs数量与SRH之间的关联。
PDs的数量是低收入非裔美国女性SRH的一个决定因素，但不是非裔美国男性SRH的决定因素，这支持了“海绵假说”。
