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Author: Harris, Gerald Alan
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1. Harris, Gerald Alan
Race, Self-Assessed Health, and the Healthy Worker Effect in a Cohort of Older Men
Ph.D. Dissertation, Rutgers: The State University of New Jersey - New Brunswick and University of Medicine and Dentistry of New Jersey, 2006. DAI-B 68/01, Jul 2007
Cohort(s): Older Men
Publisher: ProQuest Dissertations & Theses (PQDT)
Keyword(s): Health/Health Status/SF-12 Scale; Racial Differences; Self-Reporting; Socioeconomic Factors; Socioeconomic Status (SES)

Permission to reprint the abstract has not been received from the publisher.

A common method of measuring general health is by asking the respondent a straightforward question like "In general, how would you rate your health?" This self-assessed health (SAH) response is a subjective measure and may be influenced by the culture and social environment so that responses between different populations may not be comparable. In particular, black respondents may evaluate SAH differently from white respondents.

In the first part of this dissertation, I examine racial differences in SAH using the Older Men cohort of the Dept. of Labor's National Longitudinal Surveys. I find that blacks are more likely to report poor SAH than whites, but much of this difference is accounted for by socio-economic differences. For both blacks and whites, functional health is the primary correlate of poor SAH. However, leisure time and rural roots are significantly associated with poor SAH in blacks but not in whites. Still, the pervasive influence of functional health on poor SAH leads me to conclude that there is a high degree of comparability between black and white assessments of poor SAH. In the second part of the dissertation, I use poor SAH to characterize difference in the healthy worker effect by race. I find that the difference in the proportion with poor SAH between workers and non-workers is about twice as large in the black cohort than in the white cohort. However, much of the difference is accounted for by socio-economic status. However, I also find that after adjusting for SES, whites unable to work are about 1.4 times as likely to report poor SAH than blacks unable to work.

The use of SAH as a response in epidemiological studies of men where race is a factor appears to be justified when results are adjusted for SES. The use of SAH as a response in occupational studies of men where race is a factor is also justified when results are adjusted for SES as long as the cohorts studied exclude those unable to work. Among those unable to work, there are differences in how white males and black males report poor SAH.

Bibliography Citation
Harris, Gerald Alan. Race, Self-Assessed Health, and the Healthy Worker Effect in a Cohort of Older Men. Ph.D. Dissertation, Rutgers: The State University of New Jersey - New Brunswick and University of Medicine and Dentistry of New Jersey, 2006. DAI-B 68/01, Jul 2007.