Journal of Urban Health

, Volume 95, Issue 1, pp 13–20 | Cite as

The Role of Social Context in Racial Disparities in Self-Rated Health

  • Caryn N. BellEmail author
  • Roland J. ThorpeJr
  • Thomas A. LaVeist


Race disparities in self-rated health in the USA are well-documented, such that African Americans rate their health more poorly than whites. However, after adjusting for health status, socioeconomic status (SES), and health behaviors, residual race differences are observed. This suggests the importance of unmeasured variables. Because African Americans and whites tend to live in differing social contexts, it is possible that accounting for social and environmental conditions may reduce racial disparities in self-rated health. Differences in self-rated health among whites and African Americans were assessed in a low-income, urban integrated community (Exploring Health Disparities in Integrated Communities (EHDIC)) and compared with a national sample (National Health Interview Survey (NHIS)). Controlling for demographics, SES, health insurance, status, and behaviors, African Americans in NHIS had higher odds of reporting fair or poor health (odds ratio [OR] = 1.40, 95% confidence interval [CI] = 1.18–1.66) than whites. In EHDIC, there was no race difference in self-rated health (OR = 0.83, 95% CI = 0.63–1.11). These results demonstrate the importance of social context in understanding race disparities in self-rated health.


Self-rated health Race Social context 



This work was supported by the National Center on Minority Health and Health Disparities, National Institutes of Health (P60 MD000214-01) and a grant from Pfizer.


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Copyright information

© The New York Academy of Medicine 2017

Authors and Affiliations

  • Caryn N. Bell
    • 1
    Email author
  • Roland J. ThorpeJr
    • 2
    • 3
  • Thomas A. LaVeist
    • 3
    • 4
  1. 1.Department of African American StudiesUniversity of MarylandCollege ParkUSA
  2. 2.Department of Health, Behavior and SocietyJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  3. 3.Hopkins Center for Health Disparities SolutionsJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  4. 4.Department of Health Policy and ManagementGeorge Washington UniversityWashingtonUSA

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