Healthy, Wealthy & 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 university study shows, some socioeconomically disadvantaged groups in the U.S. — such as Mexicans — have better health profiles than the majority white population. Also, a Rice researcher says, the health status of men versus women varies significantly from one racial or ethnic population to another.

In the first study to systematically examine differences between the health of adult men and women in the U.S. across racial and ethnic populations, a Rice sociologist reports that gender inequalities in health can vary significantly among racial and ethnic groups. Furthermore, some minority racial groups have health profiles superior to non-Hispanic whites, despite their being socioeconomically disadvantaged.

“Mexican men and women in the U.S., 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,” says Rice sociologist Bridget Gorman.

“Black women, on the other hand, have the highest rates of life-threatening 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 an article to be published in Social Science and Medicine , “Gender Inequalities in U.S. Adult Health: The Interplay of Race and Ethnicity,” Gorman and Jen’nan G. Read at 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 account for differences between men and women within the same racial group,” Gorman says.

In some cases, according to Gorman, socioeconomic status does not explain the gap between men and women’s health regardless of race. All women, for example, are more likely than men to experience functional limitations, ranging from 39% odds for white women versus white men to 81% for Cuban women when compared with their male counterparts. The gender difference for these disabilities represents the largest health disparity between men and women in any racial group.

“Even when accounting for socioeconomic status and other lifestyle conditions, this health disadvantage remains significant for women of all races,” Gorman says.

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 for 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 U.S., 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 worse.”

Given the increased complexity of America’s health profile, Gorman believes their findings have several implications for future research and for 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 genders race needs to be taken into account as do multiple indicators beyond just men’s and women’s self-rated health.”

In addition to her research on gender differences in morbidity and mortality, Gorman has studied the influence of early life social conditions on men’s mortality as well as child and adolescent health and development. A member of Rice’s sociology faculty since 2002, she received her undergraduate degree from Western Washington University and her master’s and doctorate degrees in sociology and demography from Pennsylvania State University.

For more information at http://www.rice.edu