Racial differences in the association between self-rated health status and objective clinical measures among participants in the BARI 2D trial

Stephen B Thomas, Veronica V Sansing, Andrew Davis, Michelle Magee, Elaine Massaro, V S Srinivas, Tarek Helmy, Patrice Desvigne-Nickens, Maria Mori Brooks, BARI 2D Study Group, Stephen B Thomas, Veronica V Sansing, Andrew Davis, Michelle Magee, Elaine Massaro, V S Srinivas, Tarek Helmy, Patrice Desvigne-Nickens, Maria Mori Brooks, BARI 2D Study Group

Abstract

Objectives: We explored whether and how race shapes perceived health status in patients with type 2 diabetes mellitus and coronary artery disease.

Methods: We analyzed self-rated health (fair or poor versus good, very good, or excellent) and associated clinical risk factors among 866 White and 333 Black participants in the Bypass Angioplasty Revascularization Investigation 2 Diabetes trial.

Results: Michigan Neuropathy Screening Instrument scores, regular exercise, and employment were associated with higher self-rated health (P < .05). Blacks were more likely than were Whites to rate their health as fair or poor (adjusted odds ratio [OR] = 1.88; 95% confidence interval [CI] = 1.38, 2.57; P < .001). Among Whites but not Blacks, a clinical history of myocardial infarction (OR = 1.61; 95% CI = 1.12, 2.31; P < .001) and insulin use (OR = 1.62; 95% CI = 1.10, 2.38; P = .01) was associated with a fair or poor rating. A post-high school education was related to poorer self-rated health among Blacks (OR = 1.86; 95% CI = 1.07, 3.24; P < .001).

Conclusions: Symptomatic clinical factors played a proportionally larger role in self-assessment of health among Whites with diabetes and coronary artery disease than among Blacks with the same conditions.

Figures

FIGURE 1
FIGURE 1
Percentage of participants with fair or poor self-rated health by race and symptomatic risk factors: Bypass Angioplasty Revascularization Investigation 2 Diabetes Trial, January 2001–March 2005 Note. CHF = congestive heart failure; MI = myocardial infarction; MNSI = Michigan Neuropathy Screening Instrument; OR = unadjusted odds ratio. *P < .05; **P < .001.

Source: PubMed

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