Racial differences in the association between self-rated health status and objective clinical measures among participants in the BARI 2D trial.
OBJECTIVE
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.
Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA. sbthomas@pitt.edu
Stephen B
SB
Thomas
Veronica V
VV
Sansing
Andrew
A
Davis
Michelle
M
Magee
Elaine
E
Massaro
V S
VS
Srinivas
Tarek
T
Helmy
Patrice
P
Desvigne-Nickens
Maria Mori
MM
Brooks
D001741:Black or African American / Q000523:psychology; D000368:Aged; D016001:Confidence Intervals; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000208:ethnology / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000208:ethnology / Q000503:physiopathology; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008824:Michigan; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014481:United States; D044465:White People / Q000523:psychology