[
T H R O U G H
T H E
S A L L Y P O R T
]
“We found that socioeconomic status is more likely to explain health disparities across racial and ethnic groups than to account for differences between men and women within the same racial group.” —Bridget Gorman
In U.S., Healthy, Wealthy, and Male Usually—but Not Always—Go Together Socioeconomic status often is related to differences in health of people in the United States. However, as a new study shows, some socioeconomically disadvantaged groups in the United States have better health profiles than the majority white population. In the first study to systematically examine differences between the health of adult men and women in the United States across racial and ethnic populations, Rice sociologist Bridget Gorman reports that gender inequalities in health can vary significantly among racial and ethnic groups and that some minority racial groups have health profiles superior to non-Hispanic whites, despite their being socioeconomically disadvantaged. “Mexican men and women in the United States, for example, have among the lowest morbidity and mortality rates compared to all other racial groups, even though they rank low on most socioeconomic indicators,” Gorman says. “Black women, on the other hand, have the highest rates of lifethreatening health conditions and are nearly twice as likely as white men and women to report fair to poor health.” Although racial and gender health disparities are well documented, little is known about the differences between the health of men and women across and within racial and ethnic groups and how much socioeconomic status or other factors play a role in gender inequities in health. In “Gender Inequalities in U.S. Adult
Health: The Interplay of Race and Ethnicity,” to be published in Social Science and Medicine, Gorman and Jen’nan G. Read of the University of California at Irvine analyze the differences in men’s and women’s self-rated health, functional limitations, and life-threatening medical conditions for whites, blacks, Mexicans, Puerto Ricans, and Cubans. For each health outcome, they investigate whether socioeconomic factors can account for the disparities they observe within and across racial and ethnic groups. “We found that socioeconomic status is more likely to explain health disparities across racial and ethnic groups than to account for differences between men and women within the same racial group,” Gorman says. Socioeconomic status, according to Gorman, does not fully explain the gap between men’s and women’s health, regardless of race. All women, for example, are more likely than men to experience functional limitations, ranging from moderately increased odds for white women versus white men to much higher odds for Cuban women compared to Cuban men. “Even when accounting for socioeconomic status and other lifestyle conditions,” Gorman explains, “this health disadvantage remains significant for women of all races.” Gorman and Read used data drawn from national surveys conducted from 1997 through 2001 by the National Center for Health Statistics and the Centers for Disease Control and Prevention and administered by the U.S. Census Bureau. Adults randomly selected from each family in the National Health Interview Survey were asked to rate their general health and to report any functional limitations or diagnosis of life-threatening medical conditions they had received by a doctor or other health professional. The
researchers also controlled for the length of time the subjects had lived in the United States, their marital status, family size, socioeconomic status, lifestyle, and behavior characteristics. “Our results show the magnitude of gender difference varies considerably by racial group, health outcomes, and certain group comparisons,” Gorman says. “The gender differences within and across groups was striking for functional limitations and could not be explained by adjusting for social, economic, and health characteristics on which men and women differ.” Yet, when comparing self-reported health across racial groups, the researchers confirmed prior findings that once age and socioeconomic status were taken into account, the gender gap diminishes or disappears for all racial groups. What the researchers discovered, however, is that this was true only when women were compared to their male counterparts. “When compared to white men, only Mexican and white women were less likely to rate their health fair to poor,” Gorman says. “Even after controlling for socioeconomic status and age, black and Cuban women were still more likely to report fair to poor self-rated health than white males, with Puerto Rican women faring the worst.” Given the increased complexity of America’s health profile, Gorman believes their findings have several implications for future research and public-policy makers. “Most prior studies of health disparities between genders have controlled for race,” says Gorman. “As we’ve seen in our findings, to better understand health, differences between gender and race need to be taken into account, as do multiple indicators beyond just men’s and women’s self-rated health.”
Winter ’06
7