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.
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.
Spencer
S Melinda
SM
Department of Health Promotion, Education, and Behavior and the Institute for Southern Studies, University of South Carolina, Columbia, 29208, USA. mspencer@sc.edu
Schulz
Richard
R
Rooks
Ronica N
RN
Albert
Steven M
SM
Thorpe
Roland J
RJ
Brenes
Gretchen A
GA
Harris
Tamara B
TB
Koster
Annemarie
A
Satterfield
Suzanne
S
Ayonayon
Hilsa N
HN
Newman
Anne B
AB
D000203:Activities of Daily Living / Q000145:classification* / Q000523:psychology; D000368:Aged; D000375:Aging / Q000208:ethnology* / Q000523:psychology; D001294:Attitude to Health / Q000208:ethnology*; D044383:Black People / Q000523:psychology*; D001823:Body Composition; D003469:Culture; D004185:Disability Evaluation; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D016017:Odds Ratio; D010549:Personal Satisfaction; D012737:Sex Factors; D012944:Social Support; D044465:White People / Q000523:psychology*