Racial Non-equivalence of Socioeconomic Status and Self-rated Health among African Americans and Whites
Racial Non-equivalence of Socioeconomic Status and Self-rated Health among African Americans and Whites
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DOI：
10.1016/j.ssmph.2020.100561
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发表时间：
2020-04-01
影响因子：
4.7
通讯作者：
Thorpe, Roland J., Jr.
中科院分区：
文献类型：
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作者：
Bell, Caryn N.;Sacks, Tina K.;Thorpe, Roland J., Jr.
种族健康不平等并不能完全用社会经济地位（SES）来解释，如教育，收入和财富。在非裔美国人和白色大学毕业生中观察到最大的不平等，这表明非裔美国人没有获得相同的教育健康福利。非裔美国人没有得到相同的收入和财富回报的大学教育，他们的白色同行表明种族不平等的社会经济地位，可能会影响健康的不平等。本研究的目的是确定是否种族不平等的SES调解种族不平等的自评健康的教育和性别。使用2007-2016年美国国家健康和营养检查调查的数据，通过家庭收入>= 400%联邦贫困线，房屋所有权和投资收入，评估了种族和自评健康之间的中介关系，并按性别对大学毕业生和非大学毕业生进行了评估。在大学毕业女性（OR = 1.08，95%CI = 1.02-1.15）、非大学毕业男性（OR = 1.15，95%CI = 1.10-1.19）和女性（OR = 1.06，95%CI = 1.02-1.10）中观察到间接关联。在考虑家庭收入和财富指标后，种族和自测健康之间的直接关联仍然存在，这表明收入和财富的种族差异部分介导了自测健康中的种族不平等。这项研究表明，SES的种族非等效性对健康不公平有影响，但间接关联的程度因性别而异。其他因素，如歧视，健康悲观主义和隔离，应考虑到种族不平等的社会经济地位和种族不平等的自测健康。
Racial health inequities are not fully explained by socioeconomic status (SES) measures like education, income and wealth. The largest inequities are observed among African American and white college graduates suggesting that African Americans do not receive the same health benefits of education. African Americans do not receive the same income and wealth returns of college education as their white counterparts indicating a racial non-equivalence of SES that may affect health inequities. The aim of this study is to determine whether racial non-equivalence of SES mediates race inequities in self-rated health by education and sex. Using data from the 2007-2016 National Health and Nutrition Examination Survey in the United States, the mediation of the associations between race and self-rated health through household income >= 400% federal poverty line, homeownership, and investment income were assessed among college graduates and non-college graduates by sex. Indirect associations were observed among college graduate women (OR = 1.08, 95% CI = 1.02-1.15), and non-college graduate men (OR = 1.15, 95% CI = 1.10-1.19) and women (OR = 1.06, 95% CI = 1.02-1.10). Direct associations between race and self-rated health remained after accounting for household income and wealth indicators suggesting that race differences in income and wealth partially mediate racial inequities in self-rated health. This study demonstrates that the racial non-equivalence of SES has implications for health inequities, but the magnitude of indirect associations varied by sex. Other factors like discrimination, health pessimism and segregation should be considered in light of the racial non-equivalence of SES and racial inequities in self-rated health.