Racial differences in the association between self-rated health status and objective clinical measures among participants in the BARI 2D trial

Am J Public Health. 2010 Apr 1;100 Suppl 1(Suppl 1):S269-76. doi: 10.2105/AJPH.2009.176180. Epub 2010 Feb 10.

Abstract

Objectives: We explored whether and how race shapes perceived health status in patients with type 2 diabetes mellitus and coronary artery disease.

Methods: We analyzed self-rated health (fair or poor versus good, very good, or excellent) and associated clinical risk factors among 866 White and 333 Black participants in the Bypass Angioplasty Revascularization Investigation 2 Diabetes trial.

Results: Michigan Neuropathy Screening Instrument scores, regular exercise, and employment were associated with higher self-rated health (P < .05). Blacks were more likely than were Whites to rate their health as fair or poor (adjusted odds ratio [OR] = 1.88; 95% confidence interval [CI] = 1.38, 2.57; P < .001). Among Whites but not Blacks, a clinical history of myocardial infarction (OR = 1.61; 95% CI = 1.12, 2.31; P < .001) and insulin use (OR = 1.62; 95% CI = 1.10, 2.38; P = .01) was associated with a fair or poor rating. A post-high school education was related to poorer self-rated health among Blacks (OR = 1.86; 95% CI = 1.07, 3.24; P < .001).

Conclusions: Symptomatic clinical factors played a proportionally larger role in self-assessment of health among Whites with diabetes and coronary artery disease than among Blacks with the same conditions.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • African Americans* / psychology
  • Aged
  • Confidence Intervals
  • Coronary Artery Bypass
  • Coronary Artery Disease / ethnology
  • Coronary Artery Disease / physiopathology
  • Diabetes Mellitus, Type 2 / drug therapy
  • Diabetes Mellitus, Type 2 / ethnology
  • Diabetes Mellitus, Type 2 / physiopathology
  • European Continental Ancestry Group* / psychology
  • Female
  • Health Status Disparities*
  • Humans
  • Male
  • Michigan
  • Middle Aged
  • Multivariate Analysis
  • Odds Ratio
  • Quality of Life
  • Surveys and Questionnaires
  • United States