By: Simran Sethi

1. By: SimranSethi Health Pessimism amongst black and white adultsThe role of interpersonal and institutional maltreatment

2. Objective • Health status based on severity of the diagnosis • Subjective • Self-perceived health status • Common Factors • Gender • Socioeconomic background • Race What is health pessimism?

3. “Self-rated health” Irreplaceable when considering an individual’s health status Blacks consistentlyreport lower self-rated health than whites, even when not as physically sick. Blacks pessimism >> whites pessimism Measuring health status

4. Racism Less respect Poorer service Even in everyday activities Leads to adverse physical and mental health The relationship between perceptions of unfair treatment and self-rated health is questioned. Maltreatment and unfair treatment

5. Self concept Self-rated health self-rated status

6. Blacks are more likely to be health pessimists than whites. Adults who perceive that they are treated unfairly are more likely to be health pessimists There are race differences in terms of perception of maltreatment (both interpersonal and institutionally) and will account for an elevated risk of health pessimism amongst blacks. 3 hypotheses

7. Face-to-face interview Target population: adults in Detroit 70% response rate Questions about health related hypotheses… method

8. Would you say your health is excellent, very good, good, fair or poor? • [1] fair/poor • [0] excellent, very good, good • [If a] Doctor or health professional has told you that you have any chronic/serious illness? • How much do these health problems usually interfere with your life or activities? (Scale of 1-4) • More detailed questions Questions

9. Age, continuous • measured in years • Sex • 1 for female and 0 for male • Race • 1 for black; 0 for white respondents who indicated other 3 Socio-demographic

10. % of Poverty • Poverty line • Family income • Size of family • Education • Amount of education SOCIOECONOMIC STATUS

11. “marginalization” • Costs too much • Couldn’t get an appointment • Have to travel too far • No transportation to health care • Is there a particular doctor/clinic you go to when you are sick/need advice on health? • (0) have a regular doctor/have not seen a doctor in 1 year Access to health care

12. Exercise Diet Smoking Physical inactivity Body Mass Index (BMI) Healthy lifestyle or not?

13. Interpersonal • In your day to day life how many of the following have happened to you? a)You were treated with less respect b) You were treated with less courtesy c) You received poorer service at restaurants/stores d) People act as though they think you’re not smart • Industrial • Do you ever think you’ve been unfairly fired or denied a promotion/not been hired for a job/unfairly stopped and searched, physically threatened or abused by the police? Maltreatment

14. Three possible factors • Medical care access • How difficult is it to get to a hospital or doctor? • Health-related behaviors • Do you exercise? Do you eat junk food? Do you smoke? • Socioeconomics status • Can you pay for a regular visit to the doctor? Analytic strategy

17. Blacks with increased pessimism may be less likely to accept treatment Blacks face more unfair treatment Direct and indirect ways of interpreting Conclusions