Original article
Self-Rated Health Across Race, Ethnicity, and Immigration Status for US Adolescents and Young Adults

https://doi.org/10.1016/j.jadohealth.2015.09.006Get rights and content

Abstract

Purpose

Health disparities research seeks to understand and eliminate differences in health based on social status. Self-rated health is often used to document health disparities across racial/ethnic and immigrant groups, yet its validity for such comparative research has not been established. To be useful in disparities research, self-rated health must measure the same construct in all groups, that is, a given level of self-rated health should reflect the same level of mental and physical health in each group. This study asks, Is the relationship between self-rated health and four indicators of health status—body mass index, chronic conditions, functional limitations, and depressive symptoms—similar for adolescents and young adults of different races/ethnicities and immigrant generations?

Methods

Ordinary least squares regression was used to examine associations of self-rated health with the four indicators of health status both cross-sectionally and longitudinally using four waves of the National Longitudinal Study of Adolescent to Adult Health.

Results

Health indicators explained similar amounts of variance in self-rated health for all racial/ethnic and immigrant generation groups. The cross-sectional association between the health indicators and self-rated health did not vary across groups. The longitudinal association between depressive symptoms and chronic conditions and self-rated health also did not differ across groups. However, an increase in body mass index was associated more negatively with later self-rated health for Asians than for whites or blacks.

Conclusions

Self-rated health is valid for disparities research in large, population-based surveys of US adolescents and young adults. In many of these surveys self-rated health is the only measure of health.

Section snippets

Methods

Add Health is a nationally representative sample of young adults who were 7th–12th graders in 1994–1995. Respondents were interviewed in the home (along with one parent) in 1995 (Wave 1, ages 11–21 years), with follow-up interviews in 1996 (except for those in 12th grade at Wave 1; Wave 2, ages 11–23 years), 2001–2002 (Wave 3, ages 18–28 years), and 2008–2009 (Wave 4, ages 24–34 years) [27]. We used data from all four in-home interviews and the Wave 1 in-home parent interview. We excluded (1)

Results

At each wave, the weighted sample was approximately 67% white, 12% Latino, 14% black, 3% Asian, 3% multiracial, 5% first generation, 11% second generation, 84% third-plus generation, and 51% male. Table 1 reports self-rated health and health status by race/ethnicity and immigrant generation. There were few differences in self-rated health across groups until Wave 4, when whites had significantly better self-rated health than Latino, black, and multiracial respondents, and first-generation

Discussion

Self-rated health is frequently used to study health disparities [2], [3], [14]. Yet no studies have established that self-rated health is an equivalent construct among adolescents and young adults of different racial/ethnic groups or immigrant generations. This study addressed this critical gap [37].

With one caveat, we found self-rated health to be an equivalent construct across racial/ethnic groups and immigrant generations in this nationally representative sample. Physical and mental health

Acknowledgments

This research uses data from Add Health, a program project directed by Kathleen Mullan Harris and designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris at the University of North Carolina at Chapel Hill. Special acknowledgment is due Ronald R. Rindfuss and Barbara Entwisle for assistance in the original design. Information on how to obtain the Add Health data files is available on the Add Health Web site (http://www.cpc.unc.edu/addhealth). This article was presented at the

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    Conflicts of Interest: The authors have no conflicts of interest.

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