HEALTH PESSIMISM AMONGST BLACK AND WHITE ADULTSTHE ROLE OF INTERPERSONAL AND INSTITUTIONAL MALTREATMENT

By: Simran Sethi

WHAT IS HEALTH PESSIMISM?

Objective Health status based on severity of the

diagnosis Subjective

Self-perceived health status Common Factors

Gender Socioeconomic background Race

MEASURING HEALTH STATUS

“Self-rated health” Irreplaceable when considering an

individual’s health status Blacks consistently report lower self-

rated health than whites, even when not as physically sick.

Blacks pessimism >> whites pessimism

MALTREATMENT AND UNFAIR TREATMENT Racism Less respect Poorer service Even in everyday activities Leads to adverse physical and mental

health The relationship between perceptions

of unfair treatment and self-rated health is questioned.

SELF CONCEPT

SELF-RATED HEALTH

SELF-RATED STATUS

3 HYPOTHESES

1. Blacks are more likely to be health pessimists than whites.

2. Adults who perceive that they are treated unfairly are more likely to be health pessimists

3. There are race differences in terms of perception of maltreatment (both interpersonal and institutionally) and will account for an elevated risk of health pessimism amongst blacks.

METHOD

Face-to-face interview Target population: adults

in Detroit 70% response rate Questions about health

related hypotheses…

QUESTIONS

Would you say your health is excellent, very good, good, fair or poor? [1] fair/poor [0] excellent, very good, good

[If a] Doctor or health professional has told you that you have any chronic/serious illness?

How much do these health problems usually interfere with your life or activities? (Scale of 1-4)

More detailed questions

3 SOCIO-DEMOGRAPHIC

1. Age, continuous measured in years

2. Sex 1 for female and 0 for male

3. Race 1 for black; 0 for white respondents who

indicated other

SOCIOECONOMIC STATUS

% of Poverty Poverty line Family income Size of family

Education Amount of education

ACCESS TO HEALTH CARE

“marginalization” Costs too much Couldn’t get an appointment Have to travel too far No transportation to health care Is there a particular doctor/clinic you go to

when you are sick/need advice on health? (0) have a regular doctor/have not seen a

doctor in 1 year

HEALTHY LIFESTYLE OR NOT?

Exercise Diet Smoking Physical inactivity Body Mass Index (BMI)

MALTREATMENT

Interpersonal In your day to day life how many of the following

have happened to you?a)You were treated with less respectb) You were treated with less courtesyc) You received poorer service at restaurants/storesd) People act as though they think you’re not smart

Industrial Do you ever think you’ve been unfairly fired or

denied a promotion/not been hired for a job/unfairly stopped and searched, physically threatened or abused by the police?

ANALYTIC STRATEGY

Three possible factors Medical care access

How difficult is it to get to a hospital or doctor? Health-related behaviors

Do you exercise? Do you eat junk food? Do you smoke?

Socioeconomics status Can you pay for a regular visit to the doctor?

CONCLUSIONS

1. Blacks with increased pessimism may be less likely to accept treatment

2. Blacks face more unfair treatment 3. Direct and indirect ways of

interpreting