Erving Christy L, Zajdel Rachel
Department of Sociology, Vanderbilt University, Nashville, TN, USA.
J Racial Ethn Health Disparities. 2022 Apr;9(2):462-477. doi: 10.1007/s40615-021-00977-x. Epub 2021 Feb 5.
This study examines the association between morbidity (i.e., chronic health conditions) and self-rated health (SRH) with the aim of testing the within-group and across-group validity of SRH across nine ethnic groups: non-Latinx White, Mexican, Puerto Rican, Cuban, African American, Afro-Caribbean, Chinese, Filipino, and Vietnamese Americans. In addition, we assess whether acculturation (i.e., nativity, years of US residency, language of interview) and health-related factors (e.g., mental disorder) account for ethnic distinctions in SRH.
Data are from the National Survey of American Life (NSAL) and the National Latino and Asian American Study (NLAAS) (N = 8338). Weighted proportions and means for SRH and chronic conditions are reported. Ordered logistic regression analysis is used to determine ethnic group patterns in SRH.
Despite evidence of within-group validity of SRH for each ethnic group, our results seriously challenge the across-group validity of SRH. For example, Chinese and Vietnamese respondents report lower SRH despite having fewer chronic conditions relative to non-Latinx Whites. Moreover, Mexican Americans report fewer chronic health problems but lower SRH compared to non-Latinx Whites. Acculturation factors (e.g., language of interview) partially explain the Mexican-White difference in SRH. Among Chinese Americans, completing an interview in English is associated with higher SRH relative to those who completed an interview in Chinese.
These findings have implications for health disparities research that uses SRH as the dependent measure. Studies that compare the health profiles of diverse ethnic groups should use the SRH measure with caution, as SRH does not align with ethnic patterns of morbidity.
本研究考察发病率（即慢性健康状况）与自评健康（SRH）之间的关联，旨在检验SRH在九个种族群体中的组内和组间效度，这九个种族群体分别是：非拉丁裔白人、墨西哥裔、波多黎各裔、古巴裔、非裔美国人、非洲加勒比裔、华裔、菲律宾裔和越南裔美国人。此外，我们评估文化适应（即出生地、在美国居住的年限、访谈语言）和健康相关因素（如精神障碍）是否能解释SRH中的种族差异。
数据来自美国生活全国调查（NSAL）和美国拉丁裔与亚裔美国人研究（NLAAS）（N = 8338）。报告了SRH和慢性病的加权比例及均值。采用有序逻辑回归分析来确定SRH中的种族群体模式。
尽管有证据表明SRH在每个种族群体中具有组内效度，但我们的结果严重挑战了SRH的组间效度。例如，华裔和越南裔受访者报告的SRH较低，尽管相对于非拉丁裔白人，他们的慢性病较少。此外，墨西哥裔美国人报告的慢性健康问题较少，但与非拉丁裔白人相比，其SRH较低。文化适应因素（如访谈语言）部分解释了墨西哥裔与白人在SRH上的差异。在华裔美国人中，与用中文完成访谈的人相比，用英文完成访谈的人与更高的SRH相关。
这些发现对将SRH作为因变量的健康差异研究具有启示意义。比较不同种族群体健康状况的研究应谨慎使用SRH测量方法，因为SRH与发病率的种族模式不一致。
