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Question of race does disservice

RICE (US) — Scores of people could be underserved by a medical health form question that many take for granted.

Medical forms that ask patients to identify themselves with a single race can alter patterns of racial health disparities because some multiracial adults identify with single-race groups whose health experience is different from their own, according to a new study.

Details are reported in the journal Demography.

Placing multiracial adults into single “best race” categories overshadows the poor health of groups such as American Indians when those adults identify with a race whose members are on average healthier, such as whites.

For example, multiracial adults who say “white” best describes themselves are 38 percent more likely than single-race whites to report their health as fair or poor.

“Subsuming these multiracial groups results in an apparent worsening of the overall health profile of whites, which provides the misimpression that the gap between white health and nonwhite health is closing,” says Jenifer Bratter, associate professor of sociology at Rice University.

“If we continue to lump multiracial groups under a single race, we’re losing valuable information about the serious health issues these subgroups are facing.”

Bratter and Bridget Gorman, associate professor of sociology, studied nearly 1.8 million cases, including data from more than 27,000 multiracial adults, from the Behavioral Risk Factor Surveillance System (BRFSS) questionnaire.

The questionnaire asked respondents a standard set of questions about demographics, current health-related perceptions, conditions, and behaviors. Respondents were asked to first identify all races that applied to them, and then asked to choose the one that best represented them. They were also asked to rate their general health on a five-point scale, with one being “poor” and five “excellent.”

Racial and multiracial differences in self-rated health for the races was then assessed: white, black or African-American, Asian, Native Hawaiian or Other Pacific Islander, American Indian, Alaska Native and other race.

Studies consistently find self-rated health to be a strong, independent predictor of morbidity and mortality; those who rate their health as poor experience a heightened risk of serious, life-threatening illness.

According to the new study, only 13.5 percent of whites report their health as fair to poor, compared with 24 percent of American Indians, 19.9 percent of blacks, and 18.4 percent of others. Single-race Asians were the least likely to report fair-to-poor health—only 8.7 percent did so.

While differences in self-rated health exist between single-race whites and multiracial whites, the percentage of single-race blacks who rated their health as fair to poor is nearly identical to that of multiracial blacks. The same is true for single-race and multiracial Asians.

“Our findings highlight the need for new approaches in understanding how race operates in a landscape where racial categories are no longer mutually exclusive yet racial inequality still exists,” says Bratter.

“This extends beyond health data to other measurements of well-being, income, poverty, and so much else.”

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