title: Valuing health in a racially and ethnically diverse community sample: an analysis using the valuation metrics of money and time.
abstract: OBJECTIVE
  Limited research in health valuation analyzes samples with high proportions of racial/ethnic minorities within the United States. The primary objective was to explore patterns of health valuation across race/ethnicity using the Collaborative Psychiatric Epidemiology Surveys. A secondary objective was to analyze whether mental health disorder and immigrant status were associated with these estimates.
  
  
  METHODS
  Health valuation questions using different metrics (time and money) were analyzed. Ordered logit models stratified across poor and moderate health tested differences by race/ethnicity, with mental health disorder and immigrant status as covariates.
  
  
  RESULTS
  Asians in moderate health and Latinos were willing to pay more for health than non-Latino whites. Asians in moderate health were willing to trade more time for health. Latinos in poor health were less willing to trade time and gave disproportionate zero-trade responses. Lifetime history of anxiety disorder was positively associated with both metrics. Immigrant status confounded money valuation for Asians in moderate health, and time valuation for Latinos in poor health.
  
  
  CONCLUSIONS
  Health valuation estimates vary across race/ethnicity depending upon the metric. Time valuation scenarios appear less feasible for Latinos in poor health. More research is necessary to understand these differences and the role of immigrant status in health valuation.
authors.affiliation: Center For Multicultural Mental Health Research, Cambridge Health Alliance and Harvard Medical School, 120 Beacon Street, 4th Floor, Somerville, MA 02143, USA. nmulvaney-day@charesearch.org
authors.forename: Norah E
authors.initials: NE
authors.lastname: Mulvaney-Day
authors.forename: Marcela
authors.initials: M
authors.lastname: Horvitz-Lennon
authors.forename: Chih-Nan
authors.initials: CN
authors.lastname: Chen
authors.forename: Mara
authors.initials: M
authors.lastname: Laderman
authors.forename: Margarita
authors.initials: M
authors.lastname: Alegría
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001213:Asian / Q000523:psychology* / Q000706:statistics & numerical data; D001294:Attitude to Health / Q000208:ethnology; D004641:Emigration and Immigration; D005260:Female; D005382:Financing, Personal; D006304:Health Status; D006306:Health Surveys; D006630:Hispanic or Latino / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000191:economics / Q000453:epidemiology / Q000523:psychology; D008875:Middle Aged; D013995:Time; D014481:United States / Q000453:epidemiology; D026712:Value of Life / Q000191:economics*; D055815:Young Adult