Investigation of the Predictors of Self-rated Health of Economically Disadvantaged African American Men and Women: Evidence for Sponge Hypothesis

Abstract

Abstract<br />Background and aims: According to the sponge hypothesis, compared to men's self-rated health (SRH),<br />women's SRH is more likely to reflect conditions other than chronic medical conditions (CMCs) such<br />as psychiatric disorders (PDs). As a result, poor SRH is a weaker predictive factor for mortality risk for<br />women than men. Most of this literature, however, is done in samples that are predominantly middleclass<br />White. To test the sponge hypothesis among economically disadvantaged African Americans<br />(AAs), this study compared low-income AA men and women for the effects of the number of PDs and<br />CMCs on SRH.<br />Materials and Methods: This cross-sectional study recruited a non-random sample (n = 150) of<br />economically disadvantaged AA adults with PD(s). Structured face-to-face interviews were used to<br />collect data. SRH was measured using a single-item measure. PDs and CMCs were also self-reported.<br />We applied linear regression models to test the interactions between SRH and the number of PDs and<br />CMC as well as gender.<br />Results: The number of PDs and CMCs were associated with SRH in the pooled sample of low-income<br />AA adults with PD(s). However, we found a significant interaction between the number of PDs and<br />gender. This interaction suggested a stronger association between PDs and SRH for AA women than<br />AA men. Gender did not alter the association between the number of CMCs and SRH.<br />Conclusion: The number of PDs is a determinant of SRH for low-income AA women but not AA men,<br />supporting the sponge hypothesis.