Racial disparities in self-rated health: trends, explanatory factors, and the changing role of socio-demographics.
Racial disparities in self-rated health: trends, explanatory factors, and the changing role of socio-demographics.
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DOI：
10.1016/j.socscimed.2013.11.021
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发表时间：
2014-03
影响因子：
5.4
通讯作者：
Masters, Ryan K.
中科院分区：
文献类型：
--
作者：
Beck, Audrey N.;Finch, Brian K.;Lin, Shih-Fan;Hummer, Robert A.;Masters, Ryan K.
本文使用来自美国国家健康访谈调查（N = 1,513,097）的数据，通过同时考虑年龄，时期和队列的独特影响的模型来描述和解释黑人-白人健康差异的时间模式。首先，我们采用交叉分类随机效应年龄-时期-队列（APC）模型来记录黑人-白人自评健康在时间维度上的差异。其次，我们使用分解技术来阐明队列组成中的社会经济变化在多大程度上解释了连续出生队列中年龄和时期调整的种族健康差异。第三，我们考察了出生时的外生条件在多大程度上有助于解释连续队列中的种族差异。结果显示，在1935年前的女性群体中，黑人与白人之间的差异更大，此后有所下降；男性的差异表现出类似的模式，但在本世纪早期出生的人群中表现出缩小的趋势。社会经济构成的差异持续导致族群间的种族健康差异；值得注意的是，在最近的女性队列中，种族的婚姻状况差异越来越成为一个重要的解释因素，而在最近的男性队列中，种族的就业差异越来越突出。最后，我们的队列特征模型表明，出生时的队列经济条件（大家庭、农场或南方出生的百分比）有助于解释男性和女性在健康方面的种族差异。
This paper uses data from the U.S. National Health Interview Surveys (N = 1,513,097) to describe and explain temporal patterns in black-white health disparities with models that simultaneously consider the unique effects of age, period, and cohort. First, we employ cross-classified random effects age–period–cohort (APC) models to document black-white disparities in self-rated health across temporal dimensions. Second, we use decomposition techniques to shed light on the extent to which socio-economic shifts in cohort composition explain the age and period adjusted racial health disparities across successive birth cohorts. Third, we examine the extent to which exogenous conditions at the time of birth help explain the racial disparities across successive cohorts. Results show that black-white disparities are wider among the pre-1935 cohorts for women, falling thereafter; disparities for men exhibit a similar pattern but exhibit narrowing among cohorts born earlier in the century. Differences in socioeconomic composition consistently contribute to racial health disparities across cohorts; notably, marital status differences by race emerge as an increasingly important explanatory factor in more recent cohorts for women whereas employment differences by race emerge as increasingly salient in more recent cohorts for men. Finally, our cohort characteristics models suggest that cohort economic conditions at the time of birth (percent large family, farm or Southern birth) help explain racial disparities in health for both men and women.
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