Race differences in self-assessed health: The role of job strain

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Title: Race differences in self-assessed health: The role of job strain
Author: Christopher Michael Messenger
Abstract: A firmly established and frequently reported pattern in the distribution of health status in the U .S . is that non -Hispanic blacks (NHB ) have higher rates of morbidity and mortality than do non -Hispanic whites (NHW ) . Although much research has examined the relationships between race and health many questions pertaining to the processes that lead to such persistent disparities remain . There is accumulating evidence showing that the psychosocial environment at work affects the mental and physical health of workers . Specifically , work characterized by heavy demands and low decision latitude have the greatest negative effect on health . Using data from a nationally representative cross -sectional survey of U .S . adults 18 years and older , a sample of NHB and NHW who were regular , permanent employees having been with their current job for at least 9 months were selected for analysis (N = 2 ,255 ) . The outcome for this project , self -assessed health (SAH ) , has been shown to be a valid and reliable measure of overall health status and a valid measure across racial /ethnic groups . There is a strong association between poor SAH and morbidity , mortality , and physical disability . Logistic regression was used to determine the odds of reporting differences in SAH on a 5 -item Likert scale ranging from excellent to poor . Those above the median score for job demands and below the median score for decision latitude were classified as having a high strain job and were compared to three other categories ; low , passive , and active strain jobs . NHB were significantly more likely to report poorer SAH (OR : 1 .26 , 95 % CI : 1 .04 -1 .54 ) and were more likely to be in a high strain job (OR : 1 .34 , 95 % CI : 1 .04 -1 .72 ) than NHW . The racial odds disparity of reporting poorer SAH was partially mediated by the addition of job strain to the model (OR : 1 .18 , 95 % CI : 0 .97 -1 .45 ) . After adjustment for potentially confounding variables , race differences in SAH were further mediated (OR : 0 .94 , 95 % CI : 0 .75 -1 .16 ) while those having a high strain job remained significantly more likely to report poorer SAH compared to those with other job types . These results demonstrate that differences in SAH by race can be mediated to non -statistical significance by accounting solely for work environment characteristics .
URI: http : / /hdl .handle .net /2152 .3 /152
Date: 2009-07-03

Citation

Race differences in self-assessed health: The role of job strain. The University of Texas Medical Branch. Available electronically from http : / /hdl .handle .net /2152 .3 /152 .

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