Abstract
Purpose
General self-efficacy has been historically assumed to have universal health implications. However, less is known about population differences in long-term health effects of general self-efficacy across diverse populations. This study compared black and white American adults for (1) the association between psychosocial and health factors and general self-efficacy at baseline, and (2) the association between baseline self-efficacy and long-term risk of all-cause mortality over 25 years.
Methods
The Americans’ Changing Lives (ACL) study, 1986–2011, is a nationally representative longitudinal cohort of US adults. The study followed 3361 black (n = 1156) and white (n = 2205) adults for up to 25 years. General self-efficacy as well as demographics, socioeconomics, stressful life events, health behaviors, obesity, depressive symptoms, and self-rated health were measured at baseline in 1986. The outcome was time to all-cause mortality since 1986. Race was the focal moderator. Logistic regression and proportional hazards models were used for data analysis.
Results
Although blacks had lower general self-efficacy, this association was fully explained by socioeconomic factors (education and income). Our logistic regression suggested interactions between race and education, self-rated health, and stress on general self-efficacy at baseline. Baseline general self-efficacy was associated with risk of mortality in the pooled sample. Race interacted with baseline general self-efficacy on mortality risk, suggesting stronger association for whites than blacks.
Conclusion
Black-white differences exist in psychosocial and health factors associated with self-efficacy in the USA. Low general self-efficacy does not increase mortality risk for blacks. Future research should test whether socioeconomic status, race-related attitudes, world views, attributions, and locus of control can potentially explain why low self-efficacy is not associated with higher risk of mortality among American blacks.
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Funding
Shervin Assari is supported by the Heinz C. Prechter Bipolar Research Fund and the Richard Tam Foundation at the University of Michigan Depression Center. The Americans’ Changing Lives (ACL) study was supported by grant no. AG018418 from the National Institute on Aging (DHHS/NIH), and per the NIH Public Access Policy requires that peer-reviewed research publications generated with NIH support are made available to the public through PubMed Central. NIH is not responsible for the data collection or analyses represented in this article. The ACL study was conducted by the Institute of Social Research, University of Michigan.
Authors’ Contributions
Shervin Assari designed and analyzed this work and drafted and revised the paper. Shervin Assari had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) with the Helsinki Declaration of 1975, as revised in 2000. University of Michigan Institutional review board (IRB) approved the study protocol.
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The authors declare that they have no conflict of interest.
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Informed consent was obtained from all participants included in the study.
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Assari, S. General Self-Efficacy and Mortality in the USA; Racial Differences. J. Racial and Ethnic Health Disparities 4, 746–757 (2017). https://doi.org/10.1007/s40615-016-0278-0
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DOI: https://doi.org/10.1007/s40615-016-0278-0