%A Wan-Ting Liao
%T Patterns of racial differences in healthy days measures among adults age 60 and over in Pennsylvania
%X PUBLIC HEALTH SIGNIFICANCE. Older African Americans are more likely to report poorer self-rated health (SRH) than Caucasians even when individual-level characteristics, such as number of chronic conditions or education, are controlled. One explanation is health pessimism, which posits that African Americans are more pessimistic about their health because of non-health factors, such as perceived discrimination. We examined whether health pessimism or other factors explain the SRH differential between African Americans and Caucasians.
METHOD. Research participants were members of the Community Research Registry of the Claude D. Pepper Center at the University of Pittsburgh. The cohort, recruited between 2005 and 2013 (n=2,483), is a convenience sample of residents aged 60+ living in western Pennsylvania. Participants completed the CDC Healthy Days module, which includes questions on SRH. We estimated hierarchical logistic regression models to examine demographic characteristics (race, age, gender, income, and education level), health characteristics (number of diseases), life style characteristics (current tobacco use, alcohol consumption, and physical activity), and perceived number of physically and mentally unhealthy days on reports of poor or fair health.
RESULTS. African Americans were 1.6 times (95% CI=1.04, 2.45) more likely to report fair or poor SRH after controlling for demographic and health characteristics. Including lifestyle characteristics, especially physical activity and alcohol consumption attenuated the association, so that African Americans no longer differed from Caucasians in fair-poor SRH. Significant correlates of poorer SRH included male gender, less education, a greater number of diseases, number of reported unhealthy days, less physical activity, and no alcohol consumption.
CONCLUSIONS. Health pessimism but also actual poorer health and greater number of behavioral risk factors may be responsible for greater likelihood of fair or poor SRH in older African Americans. Racial differences may partially be addressed through public health effects to improve prevention of disease and reduction of poor life style behaviors. 

%D 2014
%K Self-rated health; Quality of life; Racial difference; Healthy Days Measures
%I University of Pittsburgh
%L pittir21407