Self-Rated Health Among Adult Women of Mexican Origin

Abstract

Self-rated health (SRH), a consistent predictor of mortality among diverse populations, is sensitive to health indicators and social factors. American-born Hispanics report better SRH than their foreign-born counterparts but simultaneously report poorer health indicators and have shorter life expectancy. Using a matched prospective cross-sectional design, we analyzed data from 631 agematched pairs of women, born in the United States or Mexico, enrolled in a cohort study based in Houston, Texas. Our first goal was to describe the relationships between SRH and health behaviors, physician-diagnosed chronic conditions, acculturation, and socioeconomic status (SES) by birthplace. Our second goal was to investigate the relative influence of SES, acculturation, health behaviors, and physician-diagnosed conditions in explaining expected differences in SRH between the two groups. Number of chronic conditions reported, particularly depression, more strongly influenced SRH than SES, acculturation, or reported health risk behaviors and the influence of birthplace is accounted for by these factors. KeywordsSelf-rated health; acculturation; SES; health indicators Self-rated health (SRH) is one of the most consistent predictors of morbidity and mortality (Idler & Benyamini, 1997). Regardless of ethnicity, individuals who perceive their health as fair or poor tend to report more physician visits per year, spend more days per year in bed, and are more likely to die prematurely (McGee, Liao, Cao & Cooper, 1999) than are individuals who typically rate their health as good or better. Also, among older adults, health care expenditures have been shown to be five times greater for those reporting poor health than for those reporting excellent health with hospitalization rates following a similar pattern (Bierman, Bubolz, Fisher & Wasson, 1999).Self-ratings of health vary by ethnicity and country of origin. Latinos, for example, report lower SRH than non-Hispanic whites do (Angel & Guarnaccia, 1989;Idler & Angel, 1990), and foreign-born Latinos report lower SRH than American-born Latinos do (Angel, Buckley & Finch, 2001;Finch, Hummer, Reindl & Vega, 2002). Acculturation, "the process by which immigrants assimilate into the dominant culture adopting new social norms and values," influences how Latinos understand health (Vega & Amaro, 1994). Therefore, differences in SRH between Latinos and non-Hispanic whites and between American-born and foreign-born Latinos may reflect variations in how diverse groups of people interpret the concept of health. However, the differences may also reflect variations in co-morbidities, as SRH is associated with chronic health conditions (Manor, Matthews & Power, 2001 On the other hand, these differences in SRH may indicate that men and women in different social positions and circumstances interpret health-related information differently. For example, as markers of SES (e.g., education level) increase, ratings of fair or poor health tend to decrease (McGee, Liao, Cao & Cooper, 1999). In comparison, ...

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