Race, heart disease worry and health protective behavior

doi:10.1016/0277-9536(86)90099-7

Social Science & Medicine

Volume 22, Issue 12, 1986, Pages 1355-1362

https://doi.org/10.1016/0277-9536(86)90099-7 Get rights and content

Abstract

This study links heart disease worry with self initiated changes in diet and exercise health protective behaviors (HPB), among blacks and whites. Utilizing the concept ‘vulnerability’, from the Health Belief Model, it is hypothesized that worry about heart disease will more readily translate into diet and exercise health behaviors for blacks than for whites. The data come from a national probability survey of families in the United States (N = 1167). The findings indicate substantial support for the hypothesis when both race and socioeconomic status (SES) are considered. Among whites, heart disease worry has no effect on health protective behavior. For blacks, worry about heart disease does have a pronounced effect on HPB, but only among lower SES blacks. A test for interaction indicates that the low SES black slope is significantly different than the slopes in the other race-SES categories. These finding contrast sharply with much of the traditional (system contact) prevention literature which depicts lower SES minority populations as less active in preventive behavior. A system barriers explanation is explored, which argues that lower SES minority persons turn to HPB as an alternative to impersonal public medicine. There was no support for this explanation; rather, lower SES blacks involved in health protective behavior express more confidence in the health care system.

References (22)

E. Harburg et al.
Socioecological stressor areas and black-white blood pressure: Detroit
J. chron. Dis.
(1973)
D.M. Harris et al.
Health protective behavior: an exploratory study
J. Hlth soc. Behav.
(1979)
W.C. Cockerham
Medical Sociology
(1982)
J. Howard et al.
The effects of race and occupation on hypertension mortality
Milbank meml. Fund Q. Bull.
(1970)
U.S. Department of Health Education and Welfare
Health in the United States, 1979
(1980)
I. Rosenstock
Why people use health services
Milbank meml Fund Q. Bull.
(1966)
D. Coburn et al.
Socioeconomic status and preventive health behavior
J. Hlth soc. Behav.
(1974)
D. Rosenblatt
Barriers to Medical Care for the Urban Poor
(1965)
B. Bullough
Poverty, ethnic identity and preventive health care
J. Hlth soc. Behav.
(1972)

T. Rundall et al.

The effect of income on use of preventive care: an evaluation of alternative explanations

J. Hlth soc. Behav.

(1979)

Cited by (24)

Are women worrying about heart disease?
2002, Women's Health Issues
Women at risk for coronary artery disease (CAD) may not be worried about the disease. In this study, demographic, CAD-risk, and CAD-worry data collected from Durham Veterans’ Affairs Medical Center women veterans were examined using bivariate and multivariate analysis with worry as the outcome. Excluding CAD patients (N = 64) and incomplete data (N = 17) of 328 women, 42% worried about CAD. Younger age, single marital status, obesity, family history, and hyperlipidemia were associated with worry. Of women with up to three risk factors, fewer than half worried about CAD. Higher-risk women were unconcerned about CAD. This could undermine prevention efforts.
Reported adoption of dietary fat and fiber recommendations among consumers
2000, Journal of the American Dietetic Association
Objective To identify constraints in adopting dietary fat and fiber recommendations.
Design A questionnaire was mailed to a sample of the general population, a convenience sample of persons with heart disease and cancer in 11 states, and registered dietitians in 5 states. The survey included questions on demographic and attitudinal factors that were correlated with specific practices to reduce fat intake and increase fiber intake.
Setting From the general population sample of 6,206 eligible respondents (return rate of 51.5%), those selected were respondents who indicated that they would adopt a dietary recommendation if it were good for them (n=2,682). Subsamples from the general population were matched to 362 registered dietitians and 147 persons with cancer or heart disease on selected demographic variables. Factors associated with adoption of specific behaviors were identified.
Statistical analysis performed Statistical analysis included %², factor analysis, and analysis of variance.
Results The majority of persons who said they would adopt a fat-reducing behavior if it were good for their health reported practicing that behavior often or usually. More than 60% reported consuming whole grains; however, only 15% reported eating fruits and vegetables frequently. Among the general population sample, those more likely to practice a behavior had the following characteristics: female, college educated, older than 60 years, white, higher income, no children younger than 18 years, perceived health status as excellent, and absence of chronic disease. Registered dietitians and those with chronic disease were also more likely to follow dietary fat and fiber recommendations.
Applications Nutrition education messages that lead to increased consumption of dietary fiber need to be developed. Nutrition educators should provide strategies for consumers for increasing use of fruits and vegetables in all meals. Good taste and convenience are critical components. The food industry may assist by providing a wider array of convenience entrees or side dishes that feature produce and whole grains. J Am Diet Assoc. 2000;100:52-58.
Aerobic exercise, subjective health and psychological well-being within age and gender subgroups
1996, Social Science and Medicine
This research examines relationships between different forms of aerobic exercise (swim, walk, jog, dance) and two measures of health: subjective health and psychological well-being. We hypothesize that the relationship between aerobic exercise and subjective health/well-being will be notably stronger for older than younger persons and females than males. This prediction is based on Homans' exchange theory of investments and rewards. Since social norms concerning aerobic exercise are likely to be weaker among older (than younger) persons and among women than men, older persons and women who do exercise are making special investments and should expect greater rewards (good health). The concept of ‘exercise norms’ implies social comparisons with others. Accordingly, age comparative data were analyzed to see if older persons who exercise see themselves as more active than their age peers than do younger persons. Data come from a national probability sample of 3025 adults (National Survey of Personal Health Practices and Consequences). As predicted, exercise was much more strongly related to subjective health and well-being among older than younger respondents. In the main, the gender hypothesis was not supported.
Measurement of Perceived Risk of Developing Diabetes Mellitus: A Systematic Literature Review
2023, Journal of General Internal Medicine
Exploring how structural and cognitive social capital influence preventive health behavior: Evidence from a Bottom of the Pyramid (BoP) population
2018, Health Education
Do you want to see a doctor for that? contextualizing racial and ethnic differences in care-seeking
2017, Research in the Sociology of Health Care

View all citing articles on Scopus

View full text

Race, heart disease worry and health protective behavior

Abstract

J. chron. Dis.

Health protective behavior: an exploratory study

J. Hlth soc. Behav.

Medical Sociology

The effects of race and occupation on hypertension mortality

Milbank meml. Fund Q. Bull.

Health in the United States, 1979

Why people use health services

Milbank meml Fund Q. Bull.

Socioeconomic status and preventive health behavior

J. Hlth soc. Behav.

Barriers to Medical Care for the Urban Poor

Poverty, ethnic identity and preventive health care

J. Hlth soc. Behav.

The effect of income on use of preventive care: an evaluation of alternative explanations

J. Hlth soc. Behav.