The Journals of Gerontology Series B: Psychological Sciences and Social Sciences Advance Access published online on January 27, 2009
The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, doi:10.1093/geronb/gbn007
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Racial Differences in Self-Rated Health at Similar Levels of Physical Functioning: An Examination of Health Pessimism in the Health, Aging, and Body Composition Study
1 Department of Health Promotion, Education, and Behavior and the Institute for Southern Studies, University of South Carolina, Columbia
2 University Center for Social and Urban Research, University of Pittsburgh, Pennsylvania
3 Department of Health and Behavioral Sciences, University of Colorado, Denver
4 Department of Behavioral and Community Health Sciences, University of Pittsburgh, Pennsylvania
5 Johns Hopkins Center for Health Disparities Solutions, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
6 Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina
7 Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland
8 Department of Health Care Studies, Universiteit Maastricht, Maastricht, The Netherlands
9 Department of Preventive Medicine, University of Tennessee, Knoxville
10 Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco
11 Center for Aging and Population Health, Department of Epidemiology, University of Pittsburgh, Pennsylvania
Address correspondence to S. Melinda Spencer, PhD, Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, 800 Sumter Street, Room 216, University of South Carolina, Columbia, SC 29208. Email: mspencer{at}sc.edu
 |
Abstract |
|---|
Background.: The health pessimism hypothesis suggests that Black elders are more pessimistic about health than Whites and therefore tend to report lower self-rated health (SRH) at comparable health status. The current analysis examined the factors associated with SRH and tested the health pessimism hypothesis among older adults at similar levels of physical functioning.
Methods.: The study example included 2,729 Health, Aging, and Body Composition study participants aged 70–79 years. We used hierarchical logistic regression to examine the association between race and SRH while adjusting for demographic, physical health, and psychosocial factors. The analyses were repeated for participants at similar levels of objective functioning to test the health pessimism hypothesis.
Results.: The association between race and SRH remained independent of physical and psychosocial health variables, with Whites being 3.7 times more likely than Black elders to report favorable SRH. This association was significant at each level of physical functioning and greater at the higher (odds ratio [OR] = 5.5) versus lower (OR = 2.2) levels of functioning.
Conclusions.: The results suggest greater health pessimism among Black elders and expand previous work by including objective functioning in multidimensional models to deconstruct race variations in the SRH of older adults.
Key Words: Self-rated health • Health pessimism • Objective measures • Physical functioning
Received January 31, 2008; Accepted August 13, 2008