African-Americans perceive people with extreme health problems as less productive and valuable

May 24 2007

African Americans appear to perceive people with extreme health problems as less productive or valuable according to a study published in the Journal of Clinical Epidemiology.

The study examined the differences in preferences for the EQ-5D health states among African Americans, Hispanics, and other races living in the United States.

For this study, one of the first studies to examine the determinants of health preferences, 4,048 individuals were selected for participation and interviewed in their homes by trained field interviewers. During the interview, respondents were asked to place values on various states of health, such as extreme pain, unconscious, and imminent death.

"It was found that race was a significant predictor for the valuation of health states," said Dr. Jeffrey Johnson, researcher at the University of Alberta. "Although this result is significant, it is not immediately apparent why African Americans valued health states more highly than members of racial and ethnic groups."

Possible reasons for this difference include racial differences in risk attitude, which characterizes a person's willingness to engage in risky prospects. These results could also have been influenced by personal or cultural beliefs about health, which in turn, could have been influenced by personal experience with illness.

"A potential explanation is that the time preference for African Americans regarding health states may vary compared to other races," said Dr. Johnson. "Because of having a shorter life expectancy, the length of time a person will be in a particular health state may be of more importance to African Americans and could explain why this group associates extreme health problems with disutility."

The EQ-5D descriptive system consists of five dimensions, mobility, self-care, usual activity, pain/discomfort, and anxiety/depression. Each dimension has three levels designated simply as no problem, some problem, or extreme problem, and subjects are asked to check the level most descriptive of their current level of function or experience on each dimension.

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