TY - JOUR
T1 - Self-Rated Health Trajectories in the African American Health Cohort
AU - Ayyagari, Padmaja
AU - Ullrich, Fred
AU - Malmstrom, Theodore K.
AU - Andresen, Elena M.
AU - Schootman, Mario
AU - Miller, J. Philip
AU - Miller, Douglas K.
AU - Wolinsky, Fredric D.
PY - 2012/12/31
Y1 - 2012/12/31
N2 - Background: Self-rated health taps health holistically and dynamically blends prior health histories with current illness burdens and expectations for future health. While consistently found as an independent predictor of functional decline, sentinel health events, physician visits, hospital episodes, and mortality, much less is known about intra-individual changes in self-rated health across the life course, especially for African Americans. Materials/Methods: Data on 998 African American men and women aged 50-64 years old were taken from a probability-based community sample that was first assessed in 2000-2001 and re-assessed 1, 2, 3, 4, 7, and 9 years later. Using an innovative approach for including decedents in the analysis, semi-parametric group-based mixture models were used to identify person-centered group trajectories of self-rated health over time. Multivariable multinomial logistic regression analysis was then used to differentiate the characteristics of AAH participants classified into the different group trajectories. Results: Four self-rated health group trajectories were identified: persistently good health, good but declining health, persistently fair health, and fair but declining health. The main characteristics that differentiated the self-rated health trajectory groups from each other were age, education, smoking, morbidity (angina, congestive heart failure, diabetes, and kidney disease), having been hospitalized in the year prior to baseline, depressive symptoms, mobility limitations, and initial self-rated health. Conclusions: This is the first study to examine self-rated health trajectories separately among African Americans. Four qualitatively distinct self-rated health group trajectories were identified that call into question the accuracy of prior reports that a single, average self-rated health trajectory for African Americans adequately captures their within-group heterogeneity.
AB - Background: Self-rated health taps health holistically and dynamically blends prior health histories with current illness burdens and expectations for future health. While consistently found as an independent predictor of functional decline, sentinel health events, physician visits, hospital episodes, and mortality, much less is known about intra-individual changes in self-rated health across the life course, especially for African Americans. Materials/Methods: Data on 998 African American men and women aged 50-64 years old were taken from a probability-based community sample that was first assessed in 2000-2001 and re-assessed 1, 2, 3, 4, 7, and 9 years later. Using an innovative approach for including decedents in the analysis, semi-parametric group-based mixture models were used to identify person-centered group trajectories of self-rated health over time. Multivariable multinomial logistic regression analysis was then used to differentiate the characteristics of AAH participants classified into the different group trajectories. Results: Four self-rated health group trajectories were identified: persistently good health, good but declining health, persistently fair health, and fair but declining health. The main characteristics that differentiated the self-rated health trajectory groups from each other were age, education, smoking, morbidity (angina, congestive heart failure, diabetes, and kidney disease), having been hospitalized in the year prior to baseline, depressive symptoms, mobility limitations, and initial self-rated health. Conclusions: This is the first study to examine self-rated health trajectories separately among African Americans. Four qualitatively distinct self-rated health group trajectories were identified that call into question the accuracy of prior reports that a single, average self-rated health trajectory for African Americans adequately captures their within-group heterogeneity.
UR - http://www.scopus.com/inward/record.url?scp=84871767612&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0053278
DO - 10.1371/journal.pone.0053278
M3 - Article
C2 - 23300906
AN - SCOPUS:84871767612
SN - 1932-6203
VL - 7
JO - PloS one
JF - PloS one
IS - 12
M1 - e53278
ER -