Racial Differences in Individual and Contextual Predictors of Physical and Mental Health

Objective: We examined the statistical and spatial distributions of several important cardiovascular diseases and mental disorders among major racial groups in the United States, especially Asian Americans. We focused on factors related to socio-demographic, psychosocial, and contextual factors (i.e., community SES, racial composition, and environmental hazards).

Methods: Data were obtained from a few benchmark years of the Behavioral Risk Factors Surveillance System database, the most comprehensive and largest database of individual health outcomes and risk factors. We also supplemented it with contextual variables obtained from the census and EPA (Environmental Protection Agency). Individual and county level data were analyzed through multi-level statistical regression, mapping, spatial clustering, and spatial correlation/regression analysis.

Results: Socio-demographic, psychosocial, and contextual factors are all important predictors of major physical and mental health outcomes for major racial groups. However, the ways with which these factors affect the health status of various racial groups vary. For African Americans, low community SES and high in-group concentration usually predict their poor health; psychosocial characteristics are particularly important for Asians and Hispanics.

Conclusions: There is a wide array of factors at various levels of examination that can be associated with individual health status, but with varying degrees of significance for different racial groups. When it comes to public health policies and health-promoting resources for specific racial groups, we have to prioritize some over others in order to be more effective.