Hispanic/White Differences in Self-reported Hlth Status

目的：先前的研究一直表明，与白人相比，拉美裔更有可能自我报告总体健康状况较差。然而，目前尚不清楚这些研究在解释这些变异时是否充分控制了重要的协变量。这项研究建议(1)确定使用一套更完整的社会经济和健康协变量是否有助于解释西班牙裔自报总体健康(SROH)中观察到的差异，以及这种差异是否因性别而异；以及(2)在调整其他协变量后，确定SROH是否对(A)医生就诊和(B)拉美裔和非拉美裔白人住院具有相同的预测值。方法：1992年健康与退休研究的浪潮，由国家老龄研究所赞助，对51-61岁的成年人进行了具有全国代表性的研究，将用来分析7169名白人、895名西班牙裔和1652名黑人受访者的数据。将使用多元回归分析(OLS回归、Logistic回归和有序Logistic回归)来探讨上述目标。主要的因变量有：(1)SROH、过去12个月内的就诊次数、就诊次数和过去12个月内的住院次数。意义：这项研究对卫生保健提供者、付款人和政策制定者具有实际用途，因为SROH经常被用来确定人群和个别患者的卫生需求。这项拟议的研究将增加我们对我国增长最快的少数民族人口的健康状况和医疗保健需求的了解。最后，我们相信，这个项目是迈向一个更大项目的重要的第一步，该项目旨在探索和描述几个拉美裔亚群之间医疗保健价值观、信念和使用的差异，并验证基于更客观的健康状况衡量标准的替代健康状况衡量标准。

Aims: Prior studies have consistently shown that Hispanics are more likely to self-report poorer overall health status compared to whites. However, it is unclear whether these studies have adequately controlled for important covariates when explaining these variations. This study proposes to (1) determine if using a more complete set of socioeconomic and health covariates can help explain the observed differentials in Hispanic self-reported overall health (SROH) and whether this difference varies according to gender; and (2) determine whether SROH has the same predictive value for (a) physician visits and (b) hospitalization for Hispanics and non-Hispanic whites, after adjusting for other covariates. Methods: The 1992 wave of the Health and Retirement Study, a nationally representative study of 51-61 year old adults, sponsored by the National Institute of Aging, will be used to analyze data on 7169 white, 895 Hispanic, and 1652 black respondents. Multivariate regression analysis (OLS regression, logistic regression, and ordered logistic regression) will be used to investigate the above aims. The main dependent variables will be (1) SROH, any physician visit in past 12 months, number of physician visits, and any hospitalization in the past 12 months. Significance: This research is of practical use for health care providers, payors, and policy makers, as SROH is often used to determine the health needs of both populations and individual patients. This proposed study would add to our knowledge regarding the health status and health care needs of our fastest growing ethnic population. Lastly, we are convinced that this project is an essential first step toward a larger project designed to explore and describe variations in health care values, beliefs, and use among several Hispanic subgroups, and to validate alternative measures of health status based on more objective measures of health status for these groups.