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Race and Ethnic Disparities in Valuing Health

Author

Listed:
  • Darrell J. Gaskin

    (Department of African American Studies, University of Maryland at College Park, dgaskin@ aasp.umd.edu)

  • Kevin D. Frick

    (Departments of Health Policy and Management, Economics, Ophthalmology, and International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins School of Nursing, Baltimore, MD)

Abstract

Objective. Patient preferences are often cited as a possible explanation for disparities in treatment. However, no prior studies have examined whether there are racial and ethnic differences in preferences for health states in a general population sample. Methods. Data from 21,362 adult respondents to the 2002 Medical Expenditure Panel Survey were used to study variations in valuations of health states. Respondents' health states were valued based on the self-rated Visual Analogue Scale (VAS) and the Euro-Qol—5D using the US and UK societal scoring algorithms. Regression analyses determined whether valuations in health states varied by race or Hispanic origin, controlling for socioeconomic status and place of residence. Results. Race and ethnicity were not associated with differences in valuations of health states. However, there were systematic differences in characteristics that were controlled, such as health status, age, poverty status, and region of the country. Blacks and Hispanics had slightly higher VAS scores than whites. The negative influence of pain/ discomfort on the VAS score was greater for blacks and Hispanics. Conclusions. Racial and ethnic differences in treatment preferences probably do not result from differences in health state valuations. Future research should explore whether differences in preferences for other attributes of treatment account for differences in treatment decisions. Cost-utility researchers using the EuroQol—5D or VAS need not account for blacks' and Hispanics' systematically valuing health states differently than whites do. However, caution may be warranted when considering interventions designed to manage pain or discomfort, because blacks and Hispanics gave greater weight to that domain of health status in their valuations.

Suggested Citation

  • Darrell J. Gaskin & Kevin D. Frick, 2008. "Race and Ethnic Disparities in Valuing Health," Medical Decision Making, , vol. 28(1), pages 12-20, January.
    • Handle: RePEc:sae:medema:v:28:y:2008:i:1:p:12-20
    DOI: 10.1177/0272989X07309641
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    References listed on IDEAS

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    1. Daniel Polsky & Richard J. Willke & Karen Scott & Kevin A. Schulman & Henry A. Glick, 2001. "A comparison of scoring weights for the EuroQol© derived from patients and the general public," Health Economics, John Wiley & Sons, Ltd., vol. 10(1), pages 27-37, January.
    2. Saha, S. & Arbelaez, J.J. & Cooper, L.A., 2003. "Patient-Physician Relationships and Racial Disparities in the Quality of Health Care," American Journal of Public Health, American Public Health Association, vol. 93(10), pages 1713-1719.
    3. William F. Lawrence & John A. Fleishman, 2004. "Predicting EuroQoL EQ-5D Preference Scores from the SF-12 Health Survey in a Nationally Representative Sample," Medical Decision Making, , vol. 24(2), pages 160-169, March.
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    Cited by:

    1. Agata Łaszewska & Ayesha Sajjad & Jan Busschbach & Judit Simon & Leona Hakkaart-van Roijen, 2022. "Conceptual Framework for Optimised Proxy Value Set Selection Through Supra-National Value Set Development for the EQ-5D Instruments," PharmacoEconomics, Springer, vol. 40(12), pages 1221-1234, December.
    2. Linda Dynan, 2009. "The Contribution of Economists to Understanding Racial Health Disparities in the US," Atlantic Economic Journal, Springer;International Atlantic Economic Society, vol. 37(3), pages 213-223, September.

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